Abstract
OBJECTIVE: To report our observations on the use of Amitriptyline in the management of Cluster Headache. BACKGROUND: Amitriptyline does not find a mention in the management of Cluster Headache. Hence, this report. DESIGN/METHODS: Cluster Headache was diagnosed based on IHS diagnostic criteria. A systematic study of the effect of Amitriptyline in Cluster Headache was done at the Headache Clinic of Institute of Neurology and in Office Practice. Thirty-two patients with Cluster Headache after exclusion of structural abnormality by Imaging and with normal neurologic examination findings were included. These patients were categorized into Cluster Headaches and Cluster Headaches with overlaps of Migrainous headaches. The duration of each headache episode, the duration of each cluster and the frequency of the clusters were elicited. The severity of pain was assessed by Visual Analog Scale[VAS]. Amitriptyline in doses ranging from 25 mg to 62.5 mg/day was administered to these patients both as rescue and prophylactic medication. During the symptomatic period these patients also received NSAIDs .Those patients who had Migrainous headache overlaps were also given Flunarizine. The follow up ranged from 6 months to 4 years with a mean follow up of 21 months. RESULTS: None of the patients were free of headaches. However, the severity and duration of the Cluster was reduced in 78[percnt], pain scale by 2 on the VAS and the duration by 20 to 30[percnt]. The cluster-free period was increased by 1 to 5 months in about 60[percnt] who were on a maintenance dose of Amitriptyline. CONCLUSION: The results of this study indicate that Amitriptyline gives modest benefit as both Rescue and Prophylactic medication for Cluster Headaches.
Disclosure: Dr. Visvanathan has nothing to disclose. Dr. Chinnu has nothing to disclose. Dr. Mahadevan has nothing to disclose.
Tuesday, April 21 2015, 2:00 pm-6:30 pm
- Copyright © 2015 by AAN Enterprises, Inc.
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