Background: Migraine, a common neurological disorder, increases the risk of psychiatric disorders. Currently, the efficacy of conventional therapies is considered unsatisfactory. Acupuncture has been gaining popularity in treatment of neuropsychiatric disease. This study aimed to investigate the effect of acupuncture on medical expenditure and the risk of depression and anxiety in migraine patients. Methods: Patients with migraine were either selected for acupuncture treatment or no treatment based on the 1:1 propensity score-matched method from the Taiwanese National Health Insurance Research Database between 2000 and 2012 and followed up until the end of 2013. The observed outcome measures were comparison of medical expenditure and incidence of depression/anxiety in the two cohorts. Results: The acupuncture cohort had a lower medical expenditure within 1 year of the intervention than the non-acupuncture cohort (p < 0.001). The acupuncture cohort had a reduced risk of depression [adjusted hazard ratio [HR], 0.61, 95% confidence interval [CI], 0.39–0.95] and anxiety (adjusted HR, 0.51, 95% CI, 0.43–0.59) after adjusting for sex, age, monthly income, urbanization level, occupation category, baseline comorbidities, and medicines used. The Kaplan–Meier analysis revealed that the cumulative incidence of depression and anxiety was significantly lower in the acupuncture cohort than in the non-acupuncture cohort during the 13-year follow-up period (log-rank test, p < 0.001). Conclusions: Acupuncture could reduce medical expenditure and the risk of depression and anxiety during the long-term follow-up period in migraine patients. However, the regulatory effects and mechanisms should be assessed in further clinical research.

Paeonia lactiflora (PL) was widely used for pain relief, but its effects on migraine headaches remain unclear. The aim of the present study was to investigate the effects of PL on migraine headaches. First, we found that PL was frequently used in Taiwan for headache treatment based on data from Taiwan's National Health Insurance Research Database. Migraine was induced through the intraperitoneal injection (i.p.) of nitroglycerin (NTG, 10 mg/kg) in rats. Pretreatment with PL was administered orally 30 min prior to the NTG i.p. Migraine headache behavior was observed by video-recordings. Finally, the rats were sacrificed and brain was removed for immunohistochemistry staining analysis. The frequency and total time spent rearing up and sniffing in exploratory behavior, and walking in locomotor behavior, were reduced in the NTG group compared with the control group (all p < 0.001). This reduction could be ameliorated by pretreatment with PL 1.0 g/kg (all p < 0.05). Total time spent in the light chamber was lower in the NTG group compared with the control group (p < 0.05); this could be ameliorated by pretreatment with 1.0 g/kg PL (p < 0.05). The rats in the NTG group spent longer time on the smooth surface than those in the control group (p < 0.001); this could be shortened by pretreatment with 0.5 and 1.0 g/kg PL (both p < 0.01). The traveling distance of rats in the NTG group was shorter than in the control group (p < 0.001); rats given 1.0 g/kg PL had a longer traveling distance than those in the NTG group (p < 0.01). Both c-fos and CGRP immunoreactive cells increased in the TNC in the NTG group compared with that of the control group (both p < 0.001); this increased could be reduced by pretreatment with PL 0.5 and 1.0 g/kg (both p < 0.05). Pretreatment with PL ameliorated migraine headache behaviors in the NTG-induced migraine rat model, suggesting pretreatment with PL is beneficial for migraine headache treatment. This effect of PL is related to the decrease of c-fos and CGRP in the TNC. However, still there are too many methodological limitations which need to be overcome in further experiments to support the data.