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Management of Chronic Daily Headache Utilizing a Uniform Treatment Pathway
Author(s) -
Rothrock John F.
Publication year - 1999
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1046/j.1526-4610.1999.3909650.x
Subject(s) - medicine , amitriptyline , anesthesia , phenelzine , biochemistry , chemistry , monoamine oxidase , enzyme
Objective.—To determine if the use of a uniform treatment pathway might be effective in treating patients with primary chronic daily headache. Methods.—Thirty‐three consecutive patients with primary chronic daily headache were managed according to a treatment pathway which involved sequential administration of divalproex sodium, amitriptyline, amitriptyline plus phenelzine, or methadone. Results.—Twenty‐two patients (67%) reported a 50% or greater reduction in headache days per month following initiation of treatment. Most positive treatment responses (17 [77%] of 22) were attributed to divalproex sodium. Conclusion.—Implementation of a uniform treatment pathway may result in significant clinical improvement in a sizable proportion of patients with chronic daily headache.