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Titolo:
Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination - A randomizedcontrolled trial
Autore:
Holroyd, KA; ODonnell, FJ; Stenland, M; Lipchik, GL; Cordingley, GE; Carlson, BW;
Indirizzi:
Ohio Univ, Coll Osteopath Med, Athens, OH 45701 USA Ohio Univ Athens OH USA 45701 v, Coll Osteopath Med, Athens, OH 45701 USA Ohio Univ, Dept Psychol, Athens, OH 45701 USA Ohio Univ Athens OH USA 45701 io Univ, Dept Psychol, Athens, OH 45701 USA OrthoNeuro, Headache Treatment & Res, Westerville, OH USA OrthoNeuro Westerville OH USA dache Treatment & Res, Westerville, OH USA
Titolo Testata:
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
fascicolo: 17, volume: 285, anno: 2001,
pagine: 2208 - 2215
SICI:
0098-7484(20010502)285:17<2208:MOCTHW>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
DISABILITY-INVENTORY HDI; FOLLOW-UP; AMITRIPTYLINE; IMPACT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Holroyd, KA 225 Porter Hall, Athens, OH 45701 USA 225 Porter Hall Athens OH USA 45701 all, Athens, OH 45701 USA
Citazione:
K.A. Holroyd et al., "Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination - A randomizedcontrolled trial", J AM MED A, 285(17), 2001, pp. 2208-2215

Abstract

Context Chronic tension-type headaches are characterized by near-daily headaches and often are difficult to manage in primary practice. Behavioral and pharmacological therapies each appear modestly effective, but data are lacking on their separate and combined effects. Objective To evaluate the clinical efficacy of behavioral and pharmacological therapies, singly and combined, far chronic tension-type headaches. Design and Setting Randomized placebo-controlled trial conducted from August 1995 to January 1998 at 2 outpatient sites in Ohio. Participants Two hundred three adults (mean age, 37 years; 76% women) withdiagnosis of chronic tension-type headaches (mean, 26 headache d/mo). Interventions Participants were randomly assigned to receive tricyclic antidepressant (amitriptyline hydrochloride, up to 100 mg/d, or nortriptyline hydrochloride, up to 75 mg/d) medication (n=53), placebo (n=48), stress management leg, relaxation, cognitive coping) therapy (3 sessions and 2 telephone contacts) plus placebo (n=49), or stress management therapy plus antidepressant medication (n=53). Main Outcome Measures Monthly headache index scores calculated as the meanof pain ratings (0-10 scale) recorded by participants in a daily diary 4 times per day; number of days per month with at least moderate pain (pain rating greater than or equal to5), analgesic medication use, and Headache Disability Inventory scores, compared by intervention group. Results Tricyclic antidepressant medication and stress management therapy each produced larger reductions in headache activity, analgesic medication use, and headache-related disability than placebo, but antidepressant medication yielded more rapid improvements in headache activity. Combined therapy was more likely to produce clinically significant (greater than or equal to 50%) reductions in headache index scores (64% of participants) than antidepressant medication (38% of participants; P=.006), stress management therapy (35%; P=.003), or placebo (29%; P=.001). On other measures the combinedtherapy and its 2 component therapies produced similar outcomes. Conclusions Our results indicate that antidepressant medication and stressmanagement therapy are each modestly effective in treating chronic tension-type headaches. Combined therapy may improve outcome relative to monotherapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 23:39:27