Headache (chronic tension-type)

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1、main/1205_new11/01/07NeurologicaldisordersHeadache(chronictension-type)SearchdateOctober2005NicholasSilverQUESTIONSWhataretheeffectsofdrugtreatmentsforchronictension-typeheadache?...........2Whataretheeffectsofnon-drugtreatmentsforchronictension-typeheadache?........

2、6INTERVENTIONSDRUGTREATMENTSALTERNATIVETREATMENTSBeneficialLikelytobebeneficialAmitriptyline......................2Cognitivebehaviouraltherapy..........6Mirtazapine(onlyshorttermevidence)....3UnknowneffectivenessUnknowneffectivenessAcupuncture......................7S

3、erotoninreuptakeinhibitorantidepressantsIndianheadmassageNew...........8..............................0RelaxationandelectromyographicTricyclicantidepressants(otherthanbiofeedback.....................8amitriptyline)....................4TobecoveredinfutureupdatesLikely

4、tobeineffectiveorharmfulOtherpharmacologicaltreatments,includingBenzodiazepines...................4antiepilepticdrugsBotulinumtoxin....................5Regularacutepainreliefmedication......6Seeglossary
KeyMessages•Chronictension-typeheadache(CTTH)isadisorderthatevol

5、vesfromepisodictension-typehead-ache,withdailyorveryfrequentepisodesofheadachelastingminutestodays.Itaffects4.1%ofthegeneralpopulationintheUSA,andismoreprevalentinwomen(upto65%ofcases).•WefoundonlylimitedevidenceaboutthetreatmentofCTTH.Regularacutepainreliefmedicatio

6、nmayitselfleadtochronicheadachesymptomsandreducetheeffectivenessofprophylactictreatment.•WedidnotfindsufficientevidencetojudgetheeffectivenessofbenzodiazepinesorselectiveserotoninreuptakeinhibitorsintreatingCTTH,althoughbotharecommonlyassociatedwithsignificantadverse

7、effects.•AmitriptylineandmirtazapinearebothsimilarlyeffectiveinreducingthedurationandfrequencyofCTTH,althoughamitriptylineisassociatedwithalessfavourableadverseeffectprofile.Wedidnotfindevidenceexaminingtheeffectivenessofothertricyclicornoradrenergicandspecificseroto

8、nergicantidepressants.BotulinumtoxindoesnotseemtobeausefultreatmentforCTTH,andisassociatedwithseveraladverseeffectsincludingfacialw