Amitriptyline treatment in chronic drug-induced headache: A double-blind comparative pilot study

Objective.-To assess the effects of amitriptyline and sudden analgesic with drawal on headache frequency and quality of life in patients suffering from chronic daily headache related to analgesics abuse. Methods.-Seventeen nondepressed patients with chronic drug induced headache were included in a 9-week, parallel-group, randomized, double-blind, place bo-controlled study. After abrupt analgesic withdrawal, amitriptyline or an active placebo (trihexyphenidyl) was started. The primary efficacy variabl e was headache frequency recorded on a headache diary in the last 4 weeks o f each treatment. The secondary efficacy variable was quality of life (Nott ingham Health Profile). Results.-Headache frequency decreased by 45% in the amitriptyline group and by 28% in the trihexyphenidyl group. Amitriptyline enhanced all the dimens ions of quality of life and significantly improved emotional reaction and s ocial isolation. Conclusion.-This pilot study suggests a beneficial effect of amitriptyline on headache frequency and quality of life for patients with chronic drug-in duced headache.