Amitriptyline Treatment in Chronic Drug-Induced Headache: A Double-Blind Comparative Pilot Study

Authors

  • S. Descombes MD,

    1. From the Centre d'Investigation Clinique, Hôpital Purpan (Drs. Descombes, Thalamas, and Rascol)
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  • C. Brefel-Courbon MD,

    1. Service de Pharmacologie Clinique, Faculté de Médecine, Hôpitaux de Toulouse (Drs. Brefel-Courbon, Rascol, Montastruc, and Senard)
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  • C. Thalamas MD,

    1. From the Centre d'Investigation Clinique, Hôpital Purpan (Drs. Descombes, Thalamas, and Rascol)
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  • J.F. Albucher MD,

    1. Service de Neurologie, Centre Hospitalier Universitaire, Hôpital Purpan, Cedex, France.(Dr. Albucher)
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  • O. Rascol PhD,

    1. From the Centre d'Investigation Clinique, Hôpital Purpan (Drs. Descombes, Thalamas, and Rascol)
    2. Service de Pharmacologie Clinique, Faculté de Médecine, Hôpitaux de Toulouse (Drs. Brefel-Courbon, Rascol, Montastruc, and Senard)
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  • J.L. Montastruc PhD,

    1. Service de Pharmacologie Clinique, Faculté de Médecine, Hôpitaux de Toulouse (Drs. Brefel-Courbon, Rascol, Montastruc, and Senard)
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  • J.M. Senard PhD

    1. Service de Pharmacologie Clinique, Faculté de Médecine, Hôpitaux de Toulouse (Drs. Brefel-Courbon, Rascol, Montastruc, and Senard)
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Address all correspondence to Dr. C. Brefel-Courbon, Service de Pharmacologie Clinique, Faculté de Médecine, Hôpitaux de Toulouse, 37 allées Jules-Guesde, 31073 Toulouse Cedex, France.

Abstract

Objective.—To assess the effects of amitriptyline and sudden analgesic withdrawal 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, placebo-controlled study. After abrupt analgesic withdrawal, amitriptyline or an active placebo (trihexyphenidyl) was started. The primary efficacy variable was headache frequency recorded on a headache diary in the last 4 weeks of each treatment. The secondary efficacy variable was quality of life (Nottingham Health Profile).

Results.—Headache frequency decreased by 45% in the amitriptyline group and by 28% in the trihexyphenidyl group. Amitriptyline enhanced all the dimensions of quality of life and significantly improved emotional reaction and social isolation.

Conclusion.—This pilot study suggests a beneficial effect of amitriptyline on headache frequency and quality of life for patients with chronic drug-induced headache.

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