Related Experiment Video
Updated: May 14, 2026
A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
Published on: January 5, 2024
A randomized trial comparing amitriptyline versus topiramate for the prophylaxis of chronic daily headache in
Taner Sezer1, Hasan Kandemir, Fusun Alehan
1Division of Pediatric Neurology, Baskent University School of Medicine, Bahcelievler, Ankara, Turkey. taner.sezer@baskent-ank.edu.tr
Insights
Amitriptyline and topiramate are equally effective in preventing chronic daily headaches (CDH) in children. Both treatments showed similar results in reducing headache frequency and severity over four months.
Area of Science:
- Neurology
- Pediatrics
- Pharmacology
Background:
- Chronic daily headache (CDH) is a debilitating condition in children.
- Effective preventive strategies for pediatric CDH are crucial for improving quality of life.
Purpose of the Study:
- To compare the efficacy and tolerability of amitriptyline versus topiramate for preventing pediatric CDH.
- To evaluate treatment response based on headache frequency reduction and adverse events.
Main Methods:
- Prospective, double-blind, randomized study involving 57 children (aged 9-16) with CDH.
- Group A received amitriptyline (0.5 mg/kg/d), Group B received topiramate (25-100 mg/d).
- Treatment response monitored for at least 4 months.
Main Results:
- Responder rates were similar: 55% for amitriptyline and 61% for topiramate (p > 0.05).
- No significant differences in responder rates or adverse events between groups.
- No significant differences in headache severity or frequency at the end of the 4-month treatment.
Conclusions:
- Topiramate demonstrates equivalent efficacy and tolerability to amitriptyline in pediatric CDH prevention.
- Both medications are viable options for managing chronic daily headaches in children.
- Further research may explore long-term outcomes and specific patient subgroups.
Objective:
the goal of this prospective and double-blind study was to compare the efficacy of amitriptyline and topiramate for the prevention of pediatric chronic daily headache (CDH).
Research Design And Methods:
fifty-seven children (aged 9-16 yr) diagnosed with CDH were randomly assigned to two groups: group A (n = 29 patients) received amitriptyline 0.5 mg/kg/d and group B (n = 28 patients) received topiramate 25 mg/d increasing up to 100 mg/d according to patient response. Treatment response was monitored for at least 4 months.
Results:
fifty-five percent of the patients in group A responded to amitriptyline and 61% of patients in group B responded to topiramate as defined by a reduction of more than 50% in monthly headache frequency. There was no significant difference in responder rate or adverse event rate between the two groups (p > 0.05). By the end of the 4-month treatment period, there were no significant differences in the final average severity and monthly frequency of headaches between treatment groups.
Conclusion:
these results suggest that the efficacy and tolerability of topiramate is equivalent to that of amitriptyline for reducing the frequency of headache in pediatric CHD patients.
