Tricyclic antidepressants and headaches: systematic review and meta-analysis

Jackson, Jeffrey L.; Shimeall, William T.; Sessums, Laura L.; DeZee, Kent J.; Becher, Dorothy; Diemer, Margretta; Berbano, Elizabeth P.; O’Malley, Patrick G.

doi:10.1136/bmj.c5222

Cited by 155 publications

(130 citation statements)

References 63 publications

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“…Despite the short time of follow-up, a change in the headache severity and a trend to a decreased length of pain were observed in this study after the beginning of therapy or modification of previous treatment. This change, on a week to week basis, has been observed by other authors 20 .…”

supporting

confidence: 58%

Devising and validating a headache diary in a series of patients with chronic daily headache from Colombia

Torres

Otálvaro

Vargas³

et al. 2012

Arq. Neuro-Psiquiatr.

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Objective: To devise and test the reliability and validity of a brief headache diary in a series of Colombian patients with chronic daily headache. Methods: The study was designed in five stages: selection of domains (group of patients and experts); initial devising of the items (writing group); identification of non-understandable items (n=20); assessment of internal consistency (n=100); assessment of validity and assessment of sensitivity to change during seven consecutive days (n=25, 175 observations). Results: Five domains were selected: headache presence, severity and length of pain, analgesics intake, and missing workdays. The headache diary is internally consistent (≈75% of rotated variance), correlates with the medical interview (Spearman's rho and Kendall's tau over 0.8 for each domain) and it has an adequate and stable sensitivity and specificity (82 to 96%). Conclusions: This headache diary is a reliable and valid instrument and represents the most important features affecting Colombian patients with chronic daily headache.Key words: Colombia, diagnosis, headache disorders, medical records, reproducibility of results, validation studies. resumenObjetivo: Diseñar y testar la validez y reproducibilidad de un diario de cefalea en una serie de pacientes Colombianos con cefalea crónica diaria. Métodos: El estudio fue diseñado en cinco fases: selección de los dominios (grupo de pacientes y expertos); diseño inicial de los ítems (grupo redactor); identificación de ítems no comprensibles (n=20); determinación de la consistencia interna (n=100); determinación de la validez y la sensibilidad al cambio durante siete días consecutivos (n=25, 175 observaciones). Resultados: Fueron seleccionados cinco dominios: presencia, severidad y duración del dolor, ingesta de analgésicos y días laborales perdidos. El diario tiene una adecuada consistencia interna (≈75% de la varianza), se correlaciona con la entrevista médica (rho de Spearman y tau de Kendall >0.8 para cada dominio) y tiene sensibilidad y especificidad estables y satisfactorias (82 a 96%). Conclusiones: Este diario de cefalea es un instrumento confiable y registra las principales características de las cefaleas en pacientes con cefalea crónica diaria.Palabras-Clave: Colombia, diagnóstico, cefalea, registros médicos, reproducibilidad de resultados, estudios de validación.controls 5,6 . Several factors might affect the internal validity of studies in CDH patients, among them the lack of reliable measurement instruments.Lipton et al. defined CDH as headaches that occur for ≥4 hours a day on ≥15 days a month over three months 7 . In the next decade,

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supporting

confidence: 58%

Devising and validating a headache diary in a series of patients with chronic daily headache from Colombia

Torres

Otálvaro

Vargas³

et al. 2012

Arq. Neuro-Psiquiatr.

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“…Amitriptyline is a first-choice drug for tension-type headache and migraine [49] and there is evidence of it having a positive effect in FM syndrome [50]. It has mixed serotonergic and noradrenergic reuptake inhibitor properties, which may exert a variety of inhibitory effects on disturbed neurotransmission [51].…”

Section: Antidepressantsmentioning

confidence: 99%

Prevalence, clinical features and potential therapies for fibromyalgia in primary headaches

Tommaso

2012

Expert Review of Neurotherapeutics

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Fibromyalgia (FM) syndrome is predominantly related to generation and persistence of central sensitization, which is an aggravating factor for chronic headaches. This review aims to examine the last 11 years of studies on FM and primary headache comorbidity, focusing on prevalence, clinical features and treatments. Chronic forms of migraine and tension-type headache show a high frequency of FM comorbidity. The symptoms characterizing headache patients presenting with FM comorbidity are high headache frequency, poor sleep quality, pericranial tenderness, anxiety and reduction of physical performances. The effects of headache-preventive drugs on factors favoring FM comorbidity were poorly evaluated. Nonpharmacological approaches such as transcranial magnetic stimulation may be an option for treatment of chronic migraine associated with FM. Keywords: fibromyalgia • migraine • tension-type headache • therapeutic optionsPrevalence, clinical features and potential therapies for fibromyalgia in primary headaches Expert Rev. Neurother. 12(3), 287-296 (2012) THeMed ArTICLe y Migraine & Headache Learning objectivesUpon completion of this activity, participants will be able to:• Describe the prevalence and underlying pathophysiology of FM comorbid with headache • Describe the clinical characteristics of FM comorbid with headache • Describe available treatments for FM comorbid with headache Medscape: Continuing Medical Education OnlineThis activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Expert Reviews Ltd. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at http://www.medscape.org/journal/expertneurothera; (4) view/print certificate. For reprint orders, please contact reprints@expert-reviews.com CME Expert Rev. Neurother. 12(3), (2012) 288 Review Possible causes of comorbidity between fibromyalgia & primary headachesFibromyalgia (FM) is a chronic pain syndrome of unknown etiology characterized by diffuse pain over more than 3 months and tenderness in at least 11 tender point sites out of 18 [1]. The diagnostic criteria have recently been revised in view of the full consideration of the complexity of symptoms associated with generalized pain, including nonrestorative sleep, fatigue and cognitive dysfunction, with less importance attributed to the number of painful tender points [2].The causes of F...

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“…Meta-analysis of studies of tension type headache prophylaxis with oral treatment provide conflicting results: a lack of superiority of antidepressant medication or myorelaxants over placebo is reported in one study [53], and a beneficial effect of tricyclic antidepressants in two others [54,55]. No data are presented to evaluate a putative placebo effect.…”

Section: Prophylactic Treatment and Placebo Effectmentioning

confidence: 99%

Placebo and other psychological interactions in headache treatment

Autret

Valade

Debiais

et al. 2012

Deutsche Zeitschrift für Akupunktur

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We present a theory according which a headache treatment acts through a specific biological effect (when it exists), a placebo effect linked to both expectancy and repetition of its administration (conditioning), and a nonspecific psychological effect. The respective part of these components varies with the treatments and the clinical situations. During antiquity, suggestions and beliefs were the mainstays of headache treatment. The word placebo appeared at the beginning of the eighteenth century. Controversies about its effect came from an excessive interpretation due to methodological bias, inadequate consideration of the variation of the measure (regression to the mean) and of the natural course of the disease. Several powerful studies on placebo effect showed that the nature of the treatment, the associated announce, the patients' expectancy, and the repetition of the procedures are of paramount importance. The placebo expectancy is associated with an activation of pre-frontal, anterior cingular, accumbens, and periacqueducal grey opioidergic neurons possibly triggered by the dopaminergic meso-limbic system. In randomized control trials, several arms design could theoretically give information concerning the respective part of the different component of the outcome and control the natural course of the disease. However, for migraine and tension type headache attacks treatment, no three arm (verum, placebo, and natural course) trial is available in the literature. Indirect evidence of a placebo effect in migraine attack treatment, comes from the high amplitude of the improvement observed in the placebo arms (28% of the patients). This figure is lower (6%) when using the harder criterium of pain free at 2 h. But these data disregard the effect of the natural course. For prophylactic treatment with oral medication, the trials performed in the last decades report an improvement in 21% of the patients in the placebo arms. However, in these studies the duration of administration was limited, the control of attacks uncertain as well as the evolution of the co-morbid psychopathology. Considering the reviews and meta-analysis of complex prophylactic procedures, it must be concluded that their effect is mostly linked to a placebo and non-specific psychological effects. Acupuncture may have a slight specific effect on tension type headache, but not on migraine. Manual therapy studies do not exhibit difference between manipulation, mobilization, and controls; touch has no proven specific effect. A comprehensive efficacy review of biofeedback studies concludes to a small specific effect on tension type headache but not on migraine. A review of behavioral treatment conclude to an interesting mean improvement but did not demonstrated a specific effect with the exception of a four arm study including a pseudo meditation control group. Expectation-linked placebo, conditioning, and non-specific psychological effects vary according clinical situations and psychological context; likely low in RCT, high after anempathic...

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Tricyclic antidepressants and headaches: systematic review and meta-analysis

Cited by 155 publications

References 63 publications

Devising and validating a headache diary in a series of patients with chronic daily headache from Colombia

Devising and validating a headache diary in a series of patients with chronic daily headache from Colombia

Prevalence, clinical features and potential therapies for fibromyalgia in primary headaches

Placebo and other psychological interactions in headache treatment

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