TO EVALUATE THE EFFICACY, SAFETY AND TOLERABILITY OF ORAL PROPRANOLOL COMPARISON WITH ORAL AMITRIPTYLINE FOR MIGRAINE PROPHYLAXIS

DAKURI JYOTHI; SHUBHAM JAJU; N. KARUNASREE

doi:10.22159/ijpps.2022v14i7.44151

Authors

DAKURI JYOTHI Department of Pharmacology, Osmania Medical College
SHUBHAM JAJU Department of Pharmacology, Osmania Medical College
N. KARUNASREE Department of Pharmacology, Osmania Medical College

DOI:

https://doi.org/10.22159/ijpps.2022v14i7.44151

Keywords:

Migraine, Amitriptyline, Propranolol, Migraine prophylaxis

Abstract

Objective: Treatment of migraine is both therapeutic and prophylactic. Prophylactic therapy is used to prevent further attacks. Amitriptyline and Propranolol are the most commonly used drugs for prophylactic therapy. The main objective of the study is to compare the efficacy, safety, and tolerability of Amitriptyline and Propranolol.

Methods: A Prospective, Comparative, open-label study was taken up in the department of neurology, Osmania General Hospital, Hyderabad. 80 patients were randomly allocated into two groups. GROUP A with 40 patients received Tab. Amitriptyline 10 mg once daily, GROUP B with 40 patients received Tab. Propranolol 20 mg once daily at night for a period of 3 mo. The severity of the headache was measured by a 4-point pain scale and patients self–assessment migraine diary at the end of the 4th, 8th, and 12th weeks to assess treatment efficacy.

Results: The mean number of attacks in the Amitriptyline and Propranolol group decreased as the duration of treatment increased. The decrease was markedly significant in the Amitriptyline group. There was a significant reduction in the severity of attacks among the Amitriptyline group (P=<0.0000001).

Conclusion: In this study, the mean number of migraine attacks in the Amitriptyline and the Propranolol group decreased as the duration of treatment increased. The decrease was markedly significant in the Amitriptyline group. Thus, Amitriptyline is more effective in decreasing Amitriptyline is more effective than Propranolol in decreasing the number, duration, and severity of attacks.

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References

Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004;24Suppl1:9-160.

Ommurugan B, Priya A, Bairy LK. A complete review of migraine. Asian J Pharm Clin Res. 2017 Oct 1;10(10):57-62. doi: 10.22159/ajpcr.2017.v10i10.19207.

Schürks M. Genetics of migraine in the age of genome-wide association studies. J Headache Pain. 2012 Jan;13(1):1-9. doi: 10.1007/s10194-011-0399-0, PMID 22072275.

Lay CL, Broner SW. Migraine in women. Neurol Clin. 2009 May;27(2):503-11. doi: 10.1016/j.ncl.2009.01.002, PMID 19289228.

Lipton RB, Scher AI, Kolodner K, Liberman J, Steiner TJ, Stewart WF. Migraine in the United States: epidemiology and patterns of health care use. Neurology. 2002 Mar 26;58(6):885-94. doi: 10.1212/wnl.58.6.885, PMID 11914403.

Hannan MA. Study of epidemiological features of primary headache patients in a tertiary Centre in Bangladesh. Bangladesh J Neurosci. 2007 Mar;23(1):11-22.

Habib M, Alam B, Hoque A, Hoque B, Mohammad QD. Headache study of 3350 cases. Bangladesh J Neurosci. 2001 Jun;17(1):1-5.

Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000 Sep 26;55(6):754-62. doi: 10.1212/wnl.55.6.754, PMID 10993991.

Islam MA, Sultana D, Shahi MS, Hassan MS. Comparison of propranolol and amitriptyline as monotherapy for Migraine prophylaxis. J Curr Adv Med Res. 2019 Aug;6(2):77-82. doi: 10.3329/jcamr.v6i2.42698.

Osterhaus JT, Townsend RJ, Gandek B, Ware JE Jr. Measuring the functional status and well-being of patients with migraine headache. Headache. 1994 Jun;34(6):337-43. doi: 10.1111/j.1526-4610.1994.hed3406337.x, PMID 7928312.

Ramadan NM, Silberstein SD, Freitag FG, Gilbert TT, Frishberg BM. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults. Neurology. 2012 Apr 24;78(17):1337–45. doi: 10.1212/WNL.0b013e3182535d20, PMID: 22529202

Modi S, Lowder DM. Medications for migraine prophylaxis. Am Fam Phys. 2006 Jan 1;73(1):72-8. Erratum in: Am Fam Phys. 2006 Nov 15;74(10):1685.

Kabbouche MA, Gilman DK. Management of migraine in adolescents. Neuropsychiatr Dis Treat. 2008 Jun;4(3):535-48. doi: 10.2147/ndt.s495, PMID 18830400.

Parsekyan D. Migraine prophylaxis in adult patients. West J Med. 2000 Nov;173(5):341-5. doi: 10.1136/ewjm.173.5.341, PMID 11069876.

Srinish G, Chethan KG, Gopakumar KP, Santakumari SN, Nitin M. Efficacy of amitriptyline in migraine prophylaxis: a comparative study of two different doses of amitriptyline. Int J Health Sci Res. 2014 Aug;4(7):89-96.

Couch JR, Amitriptyline Versus Placebo Study Group. Amitriptyline in the prophylactic treatment of migraine and chronic daily headache. Headache. 2011 Jan;51(1):33-51. doi: 10.1111/j.1526-4610.2010.01800.x, PMID 21070231.

Couch JR, Hassanein RS. Amitriptyline in migraine prophylaxis. Arch Neurol. 1979 Nov;36(11):695-9. doi: 10.1001/archneur.1979.00500470065013, PMID 508127.

Lavenstein B. A comparative study of cyproheptadine, amitriptylins, and propranolol in the treatment of pre-adolescent migraine. Cephalalgia. 1991;11(11Suppl):122-3. doi: 10.1177/0333102491011S1166.