- Recommendation ID
- CG150/1
- Question
Amitriptyline to prevent recurrent migraine:- Is amitriptyline a clinically and cost effective prophylactic treatment for recurrent migraine?
- Any explanatory notes
(if applicable) Why this is important:- Effective prevention has the potential to make a major impact on the burden of disability caused by recurrent migraine. There are few pharmacological agents that have been proven to prevent recurrent migraine.
Amitriptyline is widely used, off‑label, to treat chronic painful disorders, including migraine. The updated evidence review (2015) found evidence comparing amitriptyline with topiramate, but not with placebo, and there was uncertainty about the effectiveness of amitriptyline as a prophylactic treatment. A double‑blind randomised controlled trial (RCT) is needed to assess the clinical and cost effectiveness of amitriptyline compared with placebo. The definition of migraine used should be that in the International classification of headache disorders II or this guideline. Outcomes should include change in patient‑reported headache days, responder rate and incidence of serious adverse events.
Source guidance details
- Comes from guidance
- Headaches in over 12s: diagnosis and management
- Number
- CG150
- Date issued
- September 2012
Other details
| Is this a recommendation for the use of a technology only in the context of research? | No |
| Is it a recommendation that suggests collection of data or the establishment of a register? | No |
| Last Reviewed | 31/05/2021 |