Comparing Two Ways to Manage Symptoms for Patients Who Have Chronic Migraine and Frequent Medication Use (The MOTS Trial), United States, 2017-2020

The Medication Overuse Treatment Strategy (MOTS) research trial sought to understand the relationship between individuals who suffer from chronic migraines and their use (or overuse) of medications to treat their migraines. A diagnosis of chronic migraines means that a person experiences headaches on 15 days or more per month with at least 8 of those days meeting the diagnostic criteria for migraine with or without aura. Of the nearly 7 million individuals in the United States who suffer from chronic migraines more than half of them overuse medication intended to relieve the symptoms. However, that overuse can bring about other medical issues. This research trial enrolled 720 chronic migraine sufferers from 34 clinics across the country. The subjects were randomized into two groups. A total of 361 patients were randomized to the treatment strategy that included migraine-preventive therapy with switching off the overused medication to an alternative used with a limited frequency, while 359 patients were randomized to migraine-preventive medication with continuation of the overused medication with no maximum limit.