Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
In Reply: Drs Rifkin and Ward argue that patients
with symptoms of depression should have been excluded from our trial to rule
out the possibility that the mechanism of the TCAs' effect on CTH was their
antidepressant activity. However, our goal was not to examine the mechanism
of the effect of TCAs, but to address specific efficacy questions,1 including whether a TCA treatment effect even exists.
Excluding all patients with symptoms of depression would have compromised
the external validity of our trial; the efficacy of the 3 treatments would
have been evaluated in a clinically unrepresentative patient sample (in which
no patient exhibited symptoms of depression).
Holroyd KA, Stensland M, Carlson BW. Antidepressant Medication for Chronic Tension Headache—Reply. JAMA. 2001;286(16):1969-1970. doi:10.1001/jama.286.16.1969