Most Read Articles
Roshini Claire Anthony, 05 Oct 2017

Olfactory impairment in older adults may point to an elevated risk of developing Parkinson’s disease (PD), particularly in Caucasian men, a small US study found.

Elvira Manzano, Yesterday
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
07 Oct 2017
Women who follow a low-fat dietary pattern appear to have reduced breast cancer mortality, according to data from the Earlier Women’s Health Initiative Dietary Modification trial.
Pearl Toh, 5 days ago
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.

Tricyclic antidepressants help ease migraine

20 Jul 2017

Tricyclic antidepressants (TCA) significantly improve headache in adults with migraine compared with placebo, according to a new meta-analysis. Furthermore, TCAs have comparable efficacies with selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).

Pooled data from seven trials showed that TCAs were significantly more effective than placebo (standardized mean difference [SMD], -0.75; 95 percent CI, -1.05 to -0.46; p<0.00001). Similarly, patients receiving TCAs were more likely to experience ≥50 percent decrease in headache (risk ratio [RR], 1.40; 0.89 to 2.20; p=0.14).

Patients who received the TCA amitriptyline had experienced significantly greater improvements at 6 months (SMD, -0.77; -1.34 to -0.20; p=0.008) than at 1 month (SMD, -0.53; -0.97 to -0.10; p=0.02) indicating increasing efficacy of the medication over time.

Withdrawal due to adverse events was marginally higher in groups that received TCA than placebo (RR, 1.73; 1.00 to 2.99; p=0.05).

Compared to SSRIs, amitriptyline did not have significantly greater impacts on headache burden (SMD, 0.16; -0.32 to 0.63; p=0.52). Similarly, the efficacy of amitriptyline was comparable to that of SNRIs (SMD, -0.13; -0.51 to 0.25; p=0.51).

Based on only one eligible study, there was no significant difference in the response rates for SSRIs and amitriptyline (RR, 1.08; 0.41 to 2.83; p=0.87). However, withdrawal rate because of adverse events was modestly higher for amitriptyline than SSRIs or SNRIs (SMD, 2.85; 0.97 to 8.41; p=0.06).

The meta-analysis involved randomized controlled trials that compared TCAs with placebo or amitriptyline with other antidepressants. Those that were animal trials, employed combination therapies and enrolled patients with secondary headaches were excluded.

Outcomes were migraine frequency and index, treatment response rate, and withdrawal rate. The Cochrane Collaboration tool was used to evaluate methodological quality of the trials.

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Most Read Articles
Roshini Claire Anthony, 05 Oct 2017

Olfactory impairment in older adults may point to an elevated risk of developing Parkinson’s disease (PD), particularly in Caucasian men, a small US study found.

Elvira Manzano, Yesterday
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
07 Oct 2017
Women who follow a low-fat dietary pattern appear to have reduced breast cancer mortality, according to data from the Earlier Women’s Health Initiative Dietary Modification trial.
Pearl Toh, 5 days ago
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.