Migraine headaches in patients with post-traumatic stress disorder tend to be more frequent and disabling, according to a study in soldiers led by Dr. Jay Erickson.  Soldiers with PTSD had almost twice as many headaches as soldiers without PTSD and were more likely to have chronic migraines (headaches on more than 15 days a month).  Treatment with preventive medications was slightly less effective in the PTSD group.  Botox injections were not tried in these patients.  It is a well established fact that patients with a history of abuse are more likely to have chronic pain, including headaches.  This is an important part of history since inclusion of psychotherapy may improve treatment outcomes in these patients and, at least in theory, using antidepressants rather than other classes of preventive drugs may be more appropriate.