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Negative predictors of clinical response to amitriptyline in Japanese patients with migraine
Author(s) -
Naito Yuika,
Ishii Masakazu,
Ishibashi Masaaki,
Kasai Hideyo,
Katoh Hirotaka
Publication year - 2018
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12209
Subject(s) - amitriptyline , medicine , migraine , odds ratio , confounding , logistic regression , allodynia , hyperalgesia , receptor , nociception
Abstract Background Migraine is the most common neurological disease. Recently, there is a wide variety of prophylactic drugs, but their effects differ among individuals. Aim To investigate clinical factors affecting the response to amitriptyline therapy and establish a scoring system for predicting the negative response to prophylactic therapy. Methods We examined clinical factors from medical records of 29 consistent responders ( CR s) and 21 inconsistent responders ( IR s) to amitriptyline. Results Multivariate analysis revealed that a past history of medication overuse headache ( MOH ) and allodynia from associated symptoms were significant factors that independently contributed to a negative response. Odds ratio of MOH was 4.489 (no vs yes; 95% CI = 1.109–14.224), and odds ratio of allodynia was 4.489 (yes vs no; 95% CI = 1.109–14.224). A predictive index ( PI ) of the negative response to amitriptyline in patients with migraine was calculated using the regression coefficients of these two factors as integers, and the index was significantly higher for IR s than CR s (1.33 ± 0.58 vs 0.76 ± 0.69, mean ± SD , P = 0.003) Conclusion The obtained PI may represent an appropriate scoring system for negative responses in patients using amitriptyline.