Amitriptyline in the treatment of headache in patients with Parkinson's disease: a double-blind placebo-controlled study

We evaluated the effect of 25 mg bid amitriptyline on muscle contraction headache in 36 patients with Parkinson's disease in a randomized double-blind placebo-controlled study. Treatment lasted 12 weeks, and we assessed the efficacy by number of days with headache, sum-of-severity score (intensity X number of days with headache), and consumption of analgesics. We also administered Hoehn-Yahr staging, the Webster Rating Scale, the Mini-Mental State, and the Zung Self-Rating Depression Scale. We assessed the patients after a 4-week run-in period and after 4, 8, and 12 weeks of treatment. Thirty-one patients (15 in the amitriptyline group and 16 in the placebo group) completed the trial. Amitriptyline reduced the intensity and the frequency of headache, whereas the placebo did not. The Zung Depression Scale and the Webster Rating Scale findings remained unchanged.