Amitriptyline in migraine prophylaxis. Changes in pattern of attacks during a controlled clinical trial

Area of Science:

• Neurology
• Clinical Pharmacology

Background:

• Migraine is a common neurological disorder characterized by recurrent headaches.
• Identifying effective treatments for migraine attacks is a significant clinical challenge.

Purpose of the Study:

• To evaluate the efficacy of amitriptyline in reducing the frequency and characteristics of migraine attacks.
• To compare the effects of amitriptyline versus placebo in a controlled trial.

Main Methods:

• A double-blind, placebo-controlled, crossover clinical trial was conducted.
• 26 volunteers with migraine participated; 20 completed the trial.
• Participants received both amitriptyline and placebo, with attack frequency and characteristics recorded.

Main Results:

• 16 out of 20 completers experienced fewer migraine attacks on amitriptyline compared to placebo.
• Amitriptyline showed the greatest efficacy in reducing attacks with short warning periods and unrecognized causes.
• The drug was most effective for shorter duration attacks, irrespective of severity, and least effective for fatigue-induced attacks with long warnings.

Conclusions:

• Amitriptyline is an effective treatment for reducing migraine attack frequency.
• The efficacy of amitriptyline varies depending on the characteristics of the migraine attack.
• A daily dosage of 10-60 mg, often taken at night, was found to be adequate for migraine management.