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November 1979

Amitriptyline in Migraine Prophylaxis

Author Affiliations

From the Departments of Neurology and Biometry and the Headache Clinic, University of Kansas Medical Center, Kansas City. Dr Couch is now with Southern Illinois University School of Medicine, Springfield.

Arch Neurol. 1979;36(11):695-699. doi:10.1001/archneur.1979.00500470065013

• In a controlled trial of amitriptyline hydrochloride in migraine prophylaxis, 100 patients received placebo for a fourweek baseline period and then were randomized in double-blind fashion to therapy with amitriptyline (47 subjects) or placebo (53 subjects) for another four to eight weeks. Subjects received up to four 25-mg tablets of amitriptyline hydrochloride or identical placebo per day. Comparing the first and second four-week periods for each patient, the conditions of 55.3% of amitriptyline subjects as opposed to 34.0% of placebo subjects were ≥ 50% improved and the difference between amitriptyline and placebo response rates was significant (P <.05). Nondepressed subjects with severe migraine and depressed subjects with less severe migraine responded best to amitriptyline, whereas depressed subjects with severe migraine had little headache relief. Amitriptyline is an effective antimigraine agent and the antimigraine effect seems relatively independent of antidepressant activity.

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