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Amitriptyline is effective in chronic but not in episodic tension-type headache: pathogenetic implications
R Cerbo1, P Barbanti, G Fabbrini
1Department of Neurosciences, University La Sapienza, Rome, Italy.
Headache
|July 17, 1998
Summary
Amitriptyline effectively treats chronic tension-type headaches but not episodic ones. Further research is needed to understand this difference in migraine prophylaxis.
Area of Science:
- Neurology
- Pharmacology
- Pain Medicine
Background:
- Amitriptyline, a tricyclic antidepressant, is recognized for treating chronic pain and migraine prophylaxis.
- Its effectiveness in episodic tension-type headache (ETTH) remains unclear.
Purpose of the Study:
- To evaluate the efficacy of amitriptyline in non-depressed patients with chronic tension-type headache (CTTH) versus ETTH.
Main Methods:
- An open-label study involving 82 non-depressed patients.
- Patients received amitriptyline 25 mg/day.
- Outcomes measured included headache frequency, duration, and analgesic consumption.
Main Results:
- Amitriptyline significantly reduced headache frequency, duration, and analgesic use in patients with CTTH (P < 0.05).
- No significant improvements were observed in patients with ETTH.
Conclusions:
- Amitriptyline demonstrates efficacy in CTTH but not ETTH at the studied dose.
- Further placebo-controlled trials, potentially with higher doses, are warranted to explore underlying mechanisms, including central nociception and peripheral myofascial factors.