A comparison of pharmacological (amitriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches.
Forty-one recurrent tension headache sufferers were randomly assigned to either cognitive-behavioral therapy (administered in a primarily home-based treatment protocol) or to amitriptyline therapy (with dosage individualized at 25, 50, or 75 mg/day). Cognitive-behavioral therapy and amitriptyline each yielded clinically significant improvements in headache activity, both when improvement was assessed with patient daily recordings (56% and 27% reduction in headache index, respectively), and when improvement was assessed with neurologist ratings of clinical improvement (94% and 69% of patients rated at least moderately improved, respectively). In instances where differences in treatment effectiveness were observed (headache index, somatic complaints, perceptions of control of headache activity), cognitive-behavioral therapy yielded somewhat more positive outcomes than did amitriptyline. Neither treatment, however, eliminated headache problems.
Holroyd
K A
KA
Department of Psychology, Ohio University, Athens 45701.
Nash
J M
JM
Pingel
J D
JD
Cordingley
G E
GE
Jerome
A
A
D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006261:Headache / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011446:Prospective Studies; D012064:Relaxation Therapy; D013315:Stress, Psychological / Q000150:complications
D000639:Amitriptyline