Antidepressants not effective in headache associated with minor closed head injury

The author compared the response to amitriptyline in headache associated with depression between twelve patients having primary depression (control group) and ten patients with depression after minor closed head injury. In the primary depression group, there was significant reduction in headache and improvement in depression. The minor closed head injury group did not show significant reduction in headache or improvement in depression. The latter group, upon further treatment with phenelzine also showed no reduction in headache or improvement in depression. Results of this study question the earlier reports of the usefulness of amitriptyline in chronic muscle contraction headache and depression associated with minor closed head injury.