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Muscle contraction headache: dexamethasone suppression test and response to amitriptyline
1Department of Neurology, New York Medical College, Lincoln Hospital, N.Y.
European Neurology
|January 1, 1989
Summary
Chronic muscle contraction headache (CMCH) patients do not show the dexamethasone suppression test (DST) pattern typical of endogenous depression, despite some shared symptoms and response to antidepressants.
Area of Science:
- Neurology
- Psychiatry
- Endocrinology
Background:
- Chronic muscle contraction headache (CMCH) shares clinical features with depression.
- Some patients with CMCH exhibit positive responses to antidepressant medications.
Purpose of the Study:
- To investigate the relationship between CMCH and depression.
- To analyze the dexamethasone suppression test (DST) pattern in CMCH patients.
- To evaluate the efficacy of amitriptyline in treating CMCH.
Main Methods:
- Twenty drug-free CMCH patients (duration ≥ 6 months) underwent DST.
- Patients were treated with amitriptyline 75 mg at bedtime.
- Headache relief and cortisol levels were assessed.
Main Results:
- Nineteen patients completed the amitriptyline treatment, reporting varied headache relief.
- All assessed cortisol levels remained within normal ranges.
- CMCH patients did not exhibit the DST pattern characteristic of endogenous depression.
Conclusions:
- The dexamethasone suppression test (DST) pattern does not support a diagnosis of endogenous depression in CMCH patients.
- Despite overlapping symptoms and antidepressant responsiveness, CMCH appears distinct from endogenous depression based on DST findings.