Non-pharmacological approaches

Several neuromodulatory, non-invasive devises have been approved by the U.S. Food and Drug Administration for both the preventive and acute treatment of migraine^{[AHS, 2019; Ashina et al., 2021]}. Some evidence from RCTs indicate that behavioural therapies can have a beneficial effects on migraine. In addition, the combined effects of  non-pharmacological and pharmacological therapies in conjunction, may be greater than either modality alone^{[AHS, 2019]}. For example, an RCT with 232 individuals with migraine who received either behavioural treatment plus placebo, beta-blocker, beta-blocker plus behavioural treatment or placebo alone found that the combined effect of beta-blocker and behavioural treatment were greater than either treatment alone^{[Holroyd et al., 2010]}.

References:
American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache 2019; 59 (1): 1–18.

Ashina M, Buse DC, Ashina H et al. Migraine: integrated approaches to clinical management and emerging treatments. Lancet 2021; 397:1505-18.

Holroyd KA, Cottrell CK, O’Donnell FJ, Cordingley GE, Drew JB, Carlson BW, Himawan L. Effect of preventive (beta blocker) treatment, behavioural migraine management, or their combination on outcomes of optimised acute treatment in frequent migraine: randomised controlled trial. BJM 2010; 341:c4871.

Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition). J Headache Pain 2019; 20(1): 57.