AMITRIPTYLINE IN THE TREATMENT OF CHRONIC TENSION-TYPE HEADACHE

In a double-blind, placebo-controlled trial, the effect of 75 mg of a slow-release formulation of amitriptyline on the clinical severity of chronic tension-type headache and on headache-associated neurophysiolo gical parameters (EMG activity, exteroceptive suppression of temporal muscle activity, contingent negative variation (CNV) and experimental pain sensitivity) was investigated. All of the patients treated had a history of headaches of many years standing, and numerous failed attem pts at treatment. In the amitriptyline group, a significant reduction in daily headache duration was already found in the third week of trea tment, while in the placebo group no significant changes in headache d uration were to be seen. In week 6 the amitriptyline group had a signi ficantly shorter daily duration of headache than the placebo group. Tr eatment did not result in any significant effects on EMG recording of pericranial muscle activity either during relaxation or contraction, o n exteroceptive suppression of the temporal muscle and on CNV. The sen sitivity to suprathreshold experimental pain, however, was significant ly reduced. The data show a statistically relevant reduction of daily headache duration in chronic tension-type headache. However, they also show that amitriptyline can only partly alleviate chronic headaches b ut cannot cure them.