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Management of chronic daily headache utilizing a uniform treatment pathway
1Ochsner Clinic, New Orleans, La., USA.
Objective:
To determine if the use of a uniform treatment pathway might be effective in treating patients with primary chronic daily headache.
Methods:
Thirty-three consecutive patients with primary chronic daily headache were managed according to a treatment pathway which involved sequential administration of divalproex sodium, amitriptyline, amitriptyline plus phenelzine, or methadone.
Results:
Twenty-two patients (67%) reported a 50% or greater reduction in headache days per month following initiation of treatment. Most positive treatment responses (17 [77%] of 22) were attributed to divalproex sodium.
Conclusion:
Implementation of a uniform treatment pathway may result in significant clinical improvement in a sizable proportion of patients with chronic daily headache.