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Titolo:
Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache
Autore:
Bendtsen, L; Jensen, R;
Indirizzi:
Univ Copenhagen, Glostrup Hosp, Dept Neurol, DK-2600 Glostrup, Denmark Univ Copenhagen Glostrup Denmark DK-2600 urol, DK-2600 Glostrup, Denmark
Titolo Testata:
CEPHALALGIA
fascicolo: 6, volume: 20, anno: 2000,
pagine: 603 - 610
SICI:
0333-1024(200007)20:6<603:ARMTIP>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRESSURE PAIN THRESHOLDS; SEROTONIN REUPTAKE INHIBITORS; NITRIC-OXIDE SYNTHASE; DOUBLE-BLIND; TRICYCLIC ANTIDEPRESSANTS; EXTEROCEPTIVE SUPPRESSION; RECEPTOR ANTAGONIST; DIABETIC NEUROPATHY; MUSCLE TENDERNESS; CROSSOVER TRIAL;
Keywords:
tension-type headache; myofascial pain; central sensitization; amitriptyline; treatment;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Bendtsen, L Univ Copenhagen, Glostrup Hosp, Dept Neurol, DK-2600 Glostrup,Denmark Univ Copenhagen Glostrup Denmark DK-2600 0 Glostrup, Denmark
Citazione:
L. Bendtsen e R. Jensen, "Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache", CEPHALALGIA, 20(6), 2000, pp. 603-610

Abstract

The tricyclic anti-depressant amitriptyline is widely used in the treatment of chronic tension-type headache. The aim of the present study was to investigate whether the analgesic effect is caused by a reduction of muscle pain or by a general reduction of pain sensitivity. Thirty-three non-depressed patients with chronic tension-type headache were treated with amitriptyline 75 mg/day and with the highly selective serotonin reuptake inhibitor citalopram 20 mg/day in a 32-week, double-blind, placebo-controlled, three-waycrossover study. At the end of each treatment period, actual headache intensity and pericranial myofascial tenderness were recorded, pressure pain detection and tolerance thresholds were measured in the finger and in the temporal region and the electrical pain threshold was measured at the labial commissure. Amitriptyline reduced tenderness and headache intensity significantly more than placebo (P = 0.01 and P = 0.04, respectively). The reduction in tenderness could be ascribed solely to the group of patients who responded to amitriptyline treatment by at least 30% reduction in headache whiletenderness was unchanged in non-responders. Amitriptyline did not affect pressure or electrical pain thresholds at any of the examined locations. Citalopram had no significant effect on any of the examined parameters. These findings indicate that amitriptyline elicits its analgesic effect in chronic myofascial pain by reducing the transmission of painful stimuli from myofascial tissues rather than by reducing overall pain sensitivity. We suggestthat this effect is caused by a segmental reduction of central sensitization in combination with a peripheral anti-nociceptive action.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 23:46:33