Amitriptyline and dexamethasone combined treatment in drug-induced headache

Cephalalgia. 1996 May;16(3):198-200. doi: 10.1046/j.1468-2982.1996.1603197.x.

Abstract

Frequent or regular intake of antimigraine drugs, including analgesics, constitutes a common cause of chronic daily headache. Discontinuation of symptomatic medication can produce an increase in head pain accompanied by withdrawal symptoms. We report the favourable outcome of treating a group of outpatients with the combination of amitriptyline, dexamethasone and sumatriptan. Dexamethasone (4 mg/day) was given intramuscularly for 2 weeks, amitriptyline orally at night (50 mg/day) for at least 6 months, and sumatriptan subcutaneously to treat acute headache attacks. Eighteen out of 20 patients abstained from drug abuse. Eleven of these 18 patients showed a marked reduction in headache frequency (at least 75% in relation to the basal value), and were considered "very good responders". The other seven patients experienced at least 50% reduction in headache frequency compared to baseline. This preliminary report suggests that drug-induced headache can be treated effectively in outpatients using dexamethasone, amitriptyline and sumatriptan in combination with significant benefit in everyday life conditions.

MeSH terms

  • Adult
  • Amitriptyline / therapeutic use*
  • Analgesics / adverse effects*
  • Dexamethasone / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Headache / chemically induced
  • Headache / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Substance Withdrawal Syndrome
  • Sumatriptan / therapeutic use*
  • Treatment Outcome

Substances

  • Analgesics
  • Amitriptyline
  • Dexamethasone
  • Sumatriptan