The efficacy and tolerability ofamitriptyline, mirtazapine, venlafaxine and citalopram in the treatment of chronic tension type headache and their effects on serum lipid levels and coagulation parametres

THE EFFICACY AND TOLERABILITY OFAMITRIPTYLINE, MIRTAZAPINE,VENLAFAXINE AND CITALOPRAM IN THE TREATMENT OF CHRONIC TENSIONTYPE HEADACHE AND THEIR EFFECTS ON SERUM LIPID LEVELS ANDCOAGULATION PARAMETRESDR. EYLEM KAYASUMMARYWe aimed to compare the efficacy of antidepressant drugs; amitriptyline, mirtazapine,venlafaxine and citalopram, for proflaxic treatment of chronic tension type headacheand evaluate their effects on serum lipid levels and coagulation parametres.We benefit from the preceding studies about the use of antidepressants for paintreatment, and the patients that used antidepressants who showed hemorrhages andalterations of lipid levels.200 patients with diagnosis of chronic tension type headache were given 25 mg/dayamitriptyline, 30 mg/day mirtazapine, 20 mg/day citalopram and 75 mg/günvenlafaxine for proflaxic treatment. At first visit and during three months observationnumber of headache days, duration of headache and the pain severity with usingVisual Analog Scale were noted. Anxiety and depression were diagnosed by usingHamilton Anxiety and Depression Scales. Serum triglyserid, total cholesterol, LDL,VLDL and HLD cholesterol levels, and protrombine time, activate tromboplastinetime, INR and platelet values were evaluated at first, 4th and 8th weeks of thetreatment.We found that four antidepressants are efficient for the proflaxic treatment of chronictension type headache. Number of headache days were less in mirtazapine usingpatients. But the efficacy of mirtazapine was least for severity of pain. Statistically noeffect shown on serum lipid levels and coagulation parametres.Our findings are supporting antidepressants are efficient in the profilaxis treatment ofchronic type tension headache. We did not determine any clinical effect on serumlipid levels and coagulation parametres. We suggest to observe patients for a muchlong period and explore the platelet function and bleeding time parametres withclinical trials.