Management of chronic daily headache utilizing a uniform treatment pathway.
OBJECTIVE
To determine if the use of a uniform treatment pathway might be effective in treating patients with primary chronic daily headache.


METHODS
Thirty-three consecutive patients with primary chronic daily headache were managed according to a treatment pathway which involved sequential administration of divalproex sodium, amitriptyline, amitriptyline plus phenelzine, or methadone.


RESULTS
Twenty-two patients (67%) reported a 50% or greater reduction in headache days per month following initiation of treatment. Most positive treatment responses (17 [77%] of 22) were attributed to divalproex sodium.


CONCLUSIONS
Implementation of a uniform treatment pathway may result in significant clinical improvement in a sizable proportion of patients with chronic daily headache.
Ochsner Clinic, New Orleans, La., USA.
J F
JF
Rothrock
D000293:Adolescent; D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D018682:GABA Agents / Q000627:therapeutic use*; D006261:Headache / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D010624:Phenelzine / Q000627:therapeutic use*; D014635:Valproic Acid / Q000627:therapeutic use*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D018682:GABA Agents; D000639:Amitriptyline; D014635:Valproic Acid; D010624:Phenelzine; D008691:Methadone