Migraine prophylaxis. A comparison of propranolol and amitriptyline
D. K. Ziegler, A. Hurwitz, R. S. Hassanein, H. A. Kodanaz, S. H. Preskorn and J. Mason
The comparative efficacy of propranolol and amitriptyline in the
prophylaxis of migraine headache was studied in 30 patients in a
double-blind, placebo-controlled, crossover design. Headache response to
medication was measured monthly by compilation of headache scores derived
from quantitative data recorded by patients in a daily diary; at each
visit, Zung and Hamilton tests for depression and the Spielberger state
test for anxiety were performed. In the absence of clinical toxicity at
monthly visits, the decision to maintain the current dose or raise it was
made by a computer, which compared current headache score with that of the
previous month. Both drugs were superior to placebo. Neither drug was
superior to the other. The effectiveness of neither drug correlated with a
decrease in anxiety or depression demonstrated by psychological testing.
