Cognitions, emotions, and behavior of patients with migraine when taking medication during an attack.

Fifty-three patients with migraine, recruited from the Dutch Society of Migraine Patients and a general practice, were investigated regarding pain, moods, thoughts, and functioning during their most recent migraine attack, using a semistructured interview. Salient findings were: the high pain intensity the patients endured before they took analgesic medication, concerns about medication damaging their health, overoptimism regarding the effect of analgesic medication, and the relatively large proportion of patients (43%) who took medication primarily to be able to continue their activities. We recommend that future clinical trials on the effects of medication on migraine should not only include the measurement of pain during the attack, but also emotions, concerns about potential side effects and the ability to continue or resume work. Furthermore, it is important to provide patients with information about the side effects of medication and to apply cognitive-behavioral techniques for improvement of their mood during the attack.