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Related Experiment Videos

Nefazodone for chronic daily headache prophylaxis: an open-label study.

J R Saper1, A E Lake, S J Tepper

  • 1Michigan Head-Pain and Neurological Institute, Ann Arbor 48104, USA.

Headache
|May 31, 2001
PubMed
Summary

Nefazodone effectively reduced chronic daily headache frequency and intensity in a 12-week study. The medication was safe and well-tolerated, showing particular benefit for patients with comorbid depression.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Nefazodone, a 5-HT2 antagonist, has a unique mechanism of action relevant to headache pathophysiology.
  • Chronic daily headache may involve 5-HT2 receptor up-regulation, similar to other migraine treatments.
  • Nefazodone's antidepressant efficacy and safety are established, but its headache prophylaxis role is untested.

Purpose of the Study:

  • To evaluate nefazodone's effectiveness for chronic daily headache prophylaxis.
  • To assess the tolerability and safety of nefazodone in this patient population.
  • To explore nefazodone's impact on quality of life and comorbid mood symptoms.

Main Methods:

  • An open-label, two-center study involving 52 patients with chronic daily headache (≥15 days/month).
  • A 4-week baseline followed by 12 weeks of nefazodone treatment (median 300 mg/day).

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  • Primary outcome measures included headache diary parameters and validated scales for depression and anxiety.

    • Main Results:

    • Significant reductions in headache intensity, duration, frequency, and impairment were observed (P<.00001).
    • 71% of completers showed ≥50% reduction in headache index; 59% had ≥75% improvement.
    • Improvements noted in quality of life, mood, and sexual function; significant benefits for patients with depression/anxiety.

    Conclusions:

    • Nefazodone shows preliminary efficacy for chronic daily headache prophylaxis.
    • The drug was safe and well-tolerated, with improved sexual function reported.
    • Nefazodone may be particularly advantageous for patients with comorbid depression and anxiety.