CHRONIC TENSION-TYPE HEADACHE, MOOD DEPRESSION AND SEROTONIN - THERAPEUTIC EFFECTS OF FLUVOXAMINE AND MIANSERINE

Forty out-patients affected by chronic tension-type headache were sele cted according to the diagnostic criteria of International Headache So ciety (IHS) Headache Classification Committee. In a controlled trial p atients received placebo for a four-week baseline period, then they we re randomized in double-blind fashion to therapy with mianserine (30-6 0 mg/day) or fluvoxamine (50-100 mg/day) for another eight-weak period . Frequency of headache, pain severity and analgesic consumption were evaluated using a self-monitoring system. Mood depression was evaluate d at 0, 4 and 8 weeks by using Zung's Self-Rating Depression Scale and Hamilton Rating Scale for Depression. Both drugs were beneficial in t he treatment of chronic tension-type headache. Non-depressed subjects with more savers headache responded best to fluvoxamine, whereas mians erine was more effective in the treatment of depressed patients with m oderate headache. These results suggest that central serotoninergic ne urotransmission can play a role in the pathophysiology of chronic tens ion-type headache also in non-depressed patients.