Original Research Article Efficacy of Amitriptyline in Migraine Prophylaxis: A Comparative Study of Two Different Doses of Amitriptyline

Background and objectives: Amitriptyline in varying dosages from 10 mg to 50 mg has been used effectively in prophylaxis of Migraine. No reliable evidence in the form of a comparative study is available regarding efficacy of a lower dose of Amitriptyline for prophylactic therapy. Hence, this study was undertaken to compare the efficacy of Amitriptyline at a lower dose of 5 mg against a standard dose of 10 mg in achieving control of Migraine symptoms. Materials and methods: This was a comparative, double-blinded, randomized controlled study with 82 patients with Migraine requiring prophylaxis. Subjects were allocated into two groups, with 41 patients in each receiving Amitriptyline 10 mg and 5 mg respectively, as once daily regimen per orally for three months. Improvement in Headache severity (0-10 numeric pain rating scale) and Migraine symptoms (9-point scale) was noted at follow-up. Results: Both groups showed significant improvement in headache and symptom scores through three months of follow-up (p-value < 0.0001, ANOVA). The improvement in the scores among patients in group A was significantly more than observed in group B. No significant adverse events were noted. Conclusion: Amitriptyline may be used with significant benefit in the prophylaxis of Migraine. Amitriptyline at a dose of 10 mg is more efficacious than that at 5 mg in controlling headache and the associated symptoms of Migraine. A minimum dose of 10 mg may be safely used without any increased risk of adverse effects