Patel Krinaben M, Popatbhai Kachhadia M, Xavier Roshni, Aramin Mohammed A S, Faris Khalid J F, Mateen Mohammed A, Prajwal Priyadarshi, Marsool Mohammed D M, Sheikh Hafsa, Mohamed Esra H A G
M.B.B.S., GMERS College, Gotri, Vadodara, Gujarat, India.
M.B.B.S., P.D.U College, Civil Hospital Campus, Rajkot, Gujarat, India.
J Family Med Prim Care. 2024 Feb;13(2):699-703. doi: 10.4103/jfmpc.jfmpc_927_23. Epub 2024 Mar 6.
Approximately 15% of migraine sufferers need preventative medicine because they have more than two episodes each month. Migraine is a regular, persistent condition that frequently makes victims helpless. Numerous drugs from various classes have so far been used in migraine prophylaxis. Their effectiveness is recurrently overshadowed by their side effects because they must be used for a long time, which occasionally necessitates stopping the drug.
In the tertiary care teaching hospital's department of medicine, a prospective, comparative, open-label study was initiated. Two groups of 80 patients were randomly chosen. For 3 months, the 40 patients in Group A were given a tablet of amitriptyline 10 mg once daily, whereas the 40 patients in Group B were given a tablet of propranolol 20 mg once a day. At the conclusion of the fourth, eighth, and twelfth weeks, the patients' own self-assessment migraine diary and a 4-point pain scale were used to grade the intensity of the headaches.
As a result, in Group A, the mean migraine attack severity in periods 1 and 2 was 5.88 2.69 and 5.41 2.48, respectively. In Group B, the mean was 5.15 2.75 in period 1 and 5.66 2.78 in period 2, respectively. The average length of a migraine attack in Group A was 20.30 5.61 h in period 1 and 16.75 5.23 h in period 2. In Group B, the mean was 16.59 3.21 in period 1 and 18.78 5.14 in period 2. Between groups A and B, there was a statistically significant difference.
The average number of migraine attacks reduced in the amitriptyline and propranolol groups as the treatment duration increased. Amitriptyline is a popular medication with established effectiveness and manageable levels of negative side effects. It is the tricyclic antidepressant that is most frequently used to prevent headaches. When administered for migraine prevention, it generates a quick response within 3 months. Propranolol is less effective than amitriptyline at reducing the frequency, length, and severity of episodes.
约15%的偏头痛患者需要预防性药物治疗，因为他们每月发作超过两次。偏头痛是一种常见的持续性疾病，常使患者无助。到目前为止，各类药物已被用于偏头痛的预防。由于这些药物必须长期使用，其副作用常常掩盖了它们的疗效，有时甚至需要停药。
在一家三级护理教学医院的内科开展了一项前瞻性、对比性、开放标签研究。随机选择两组，每组80例患者。A组40例患者连续3个月每天服用1片10毫克的阿米替林，而B组40例患者每天服用1片20毫克的普萘洛尔。在第4、8和12周结束时，使用患者自己的自我评估偏头痛日记和4级疼痛量表对头痛强度进行分级。
结果显示，A组第1阶段和第2阶段偏头痛发作的平均严重程度分别为5.88±2.69和5.41±2.48。B组第1阶段的平均值为5.15±2.75，第2阶段为5.66±2.78。A组偏头痛发作的平均时长在第1阶段为20.30±5.61小时，第2阶段为16.75±5.23小时。B组第1阶段的平均值为16.59±3.21，第2阶段为18.78±5.14。A组和B组之间存在统计学上的显著差异。
随着治疗时间的延长，阿米替林组和普萘洛尔组偏头痛发作的平均次数减少。阿米替林是一种常用药物，疗效确切，副作用水平可控。它是最常用于预防头痛的三环类抗抑郁药。用于预防偏头痛时，它在3个月内就能产生快速反应。普萘洛尔在减少发作频率、时长和严重程度方面不如阿米替林有效。
