title: Pilot study of amitriptyline in the prophylactic treatment of medication-overuse headache: a 1-year follow-up.
abstract: OBJECTIVE
  This study aims to evaluate the long-term efficacy of low-dose amitriptyline combined with abrupt withdrawal in outpatients of medication-overuse headache (MOH) in an open-label design.
  
  
  METHODS
  We evaluated the effectiveness of early introduction of low-dose amitriptyline combined with abrupt withdrawal in outpatients with MOH over a 1-year observational period. The primary outcome measures were the reduction in number of headache days and days with use of acute headache medication after 3 months and after 12 months. A number of secondary outcome measures, as well as safety and tolerability, were assessed. The responders were defined as patients with ≥50% reduction in headache frequency from baseline and being without medication overuse.
  
  
  RESULTS
  Thirty-three patients completed the study. Significant reductions in headache frequency and medication consumption were observed at both months 3 and 12, compared to baseline (P < 0.05 for all). Neither the primary nor the secondary endpoints differed significantly between months 3 and 12. At the 12-month follow-up, 58% of the patients were considered as responders (N = 19); 73% remained cured of MOH (N = 24); 64% had reverted to episodic headaches (N = 21); 27% had relapsed into MOH (N = 9).
  
  
  CONCLUSIONS
  Given these results, early introduction of low-dose amitriptyline combined with abrupt withdrawal could be considered as a choice for patients with MOH.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Fan
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Lv
authors.forename: Guomin
authors.initials: G
authors.lastname: Ying
authors.forename: Wangwen
authors.initials: W
authors.lastname: Li
authors.forename: Jiying
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D051271:Headache Disorders, Secondary / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000639:Amitriptyline
keywords: Amitriptyline; Follow-Up; Medication-Overuse Headache; Outpatient Withdrawal; Prophylaxis