Antidepressants
and stress therapy could be the right combination to knock out chronic
headaches, researchers at Ohio University report in this week's Journal
of the American Medical Association.
"Patients using
this combination cut their number of headaches in half," said Ken Holroyd,
a professor of health psychology at the university. "This is a 50 percent
reduction in headaches, compared to about one-third of people who received
either antidepressant medication or self management therapy."
Holroyd told
United Press International the study participants had daily headaches.
"Chronic tension-type
headaches occur at least 15 days per month;" he said. The study participants
averaged 26 days headaches a month.
"Chronic tension
headaches transmit pain signals to the brain at ever increasing volumes,"
he said.
For the study,
researchers gave participants one of four treatments: a placebo; an antidepressant
called amitriptyline; stress-management therapy; or a combination of amitriptyline
and stress management.
People taking
amitriptyline took the drug in low doses once a day. Stress-management
therapy involved muscle-stretching exercises, relaxation techniques and
instruction on identifying and managing stressors that often lead to headaches.
Participants
visited one of two headache clinics in the study monthly for three months.
Stress-management skills were introduced and the dose of antidepressant
medication was adjusted at each visit.
Stress-management
group participants also used manuals and audiotapes to learn and practice
their skills at home.
All patients
kept diaries of the frequency and severity of their headaches and their
use of pain-relieving medications.
Researchers
followed the participants for an additional six months to evaluate the
effects of the treatment.
Those receiving
amitriptyline recorded faster headache relief than those receiving stress-management
alone.
But the stress-management
group showed equal improvement as they learned to identify warning signs
that a headache was coming, preventing headaches and reducing the need
for medication.
Dr Robert Lyon,
of the National Neurological Institute, said the findings confirm that
chronic headaches result from multiple variables and that relief has many
facets.
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