Prevention Of Tension-type Headache Research Articles

Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison meta-analysis

BackgroundAcupuncture showed better improvement than sham acupuncture in reducing attack frequency of tension-type headache (TTH), but its effectiveness relative to first-line drugs for TTH is unknown, which impedes the recommendation of acupuncture for patients who are intolerant to drugs for TTH. We aimed to estimate the relative effectiveness between acupuncture and tricyclic antidepressants (TCAs) through indirect treatment comparison (ITC) meta-analysis.MethodsWe searched Ovid Medline, Embase, and Cochrane Library from database inception until April 13, 2023. Randomized controlled trials of TCAs or acupuncture in the prevention of TTH in adults were included. The primary outcome was headache frequency. The secondary outcomes were headache intensity, responder rate, and adverse event rate. Bayesian random-effect models were used to perform ITC meta-analysis, and confidence of evidence was evaluated by using the GRADE approach.ResultsA total of 34 trials involving 4426 participants were included. Acupuncture had similar effect with TCAs in decreasing TTH frequency (amitriptyline: mean difference [MD] -1.29, 95% CI -5.28 to 3.02; amitriptylinoxide: MD -0.05, 95% CI -6.86 to 7.06) and reducing TTH intensity (amitriptyline: MD 2.35, 95% CI -1.20 to 5.78; clomipramine: MD 1.83, 95% CI -4.23 to 8.20). Amitriptyline had a higher rate of adverse events than acupuncture (OR 4.73, 95% CI 1.42 to 14.23).ConclusionAcupuncture had similar effect as TCAs in reducing headache frequency of TTH, and acupuncture had a lower adverse events rate than amitriptyline, as shown by very low certainty of evidence.

Tension-type headache in children and adolescents: comparative study of the effectiveness of preventive therapy methods

Introduction. Late and inaccurate diagnosis of tension-type headache (TTH) leads to the lack of timely rational treatment. In children and adolescents with TTH, the role of comorbid disorders that affect the course of TTH and can contribute to their chronification is not sufficiently taken into account. Meanwhile, with timely diagnosis and adequate treatment of TTH in many children and adolescents, a significant improvement in the disease’s course and the prognosis is achieved, and clinical remission is possible. Considering the high prevalence of TTH among children and adolescents, the decline in their quality of life, and the high frequency of comorbid disorders, it is reasonable to develop effective methods of preventive treatment for TTH in this age group. The aim of the study was to evaluate the effectiveness of monotherapy with γ-amino-β-phenyl butyric acid hydrochloride, amitriptyline, or breathing gymnastics (comparison group) indicated for two months as a preventive treatment of TTH in children and adolescents in the open randomized comparative study in three parallel groups of patients. Material and methods. In an open parallel study, 90 TTH patients aged 8-16 years were divided into three groups of 30 patients (each with 15 boys and 15 girls). Results. Significant differences with the comparison group in the individual response to therapy were confirmed. According to the criterion of a 50% or more reduction in the average number of headache attacks per month in group 1 (γ-amino-β-phenyl butyric acid hydrochloride), the improvement was achieved in 56.7% of patients, in group 2 (amitriptyline) - in 73.3%, in the 3rd group (breathing gymnastics) - in 30%. According to a more strict criterion for reducing the average number of headache attacks per month by 75% or more, the response to therapy was observed in group 1 in 30%. In group 2 - in 23.3%, in group 3 - in 3.3% of patients. In groups 1 and 2, along with a significant decrease in the frequency, duration, and intensity of TTH attacks, a significant improvement in daily activity, a favorable effect on the manifestations of fatigue, anxiety disorders, and sleep disorders associated with TTH was demonstrated. The therapeutic efficacy of breathing gymnastics exercises complex was confirmed in the prevention of TTH with frequency, duration, and intensity reduction of TTH, and diminishing its impact on daily activity, a moderate decrease in manifestations of fatigue, anxiety disorders (by patients’ self-assessment), and improvement in sleep quality.

Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis.

Tension-type headaches are a common source of pain and suffering. Our purpose was to assess the efficacy of tricyclic (TCA) and tetracyclic antidepressants in the prophylactic treatment of tension-type headache. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, the ISI Web of Science, and clinical trial registries through 11 March 2017 for randomized controlled studies of TCA or tetracyclic antidepressants in the prevention of tension-type headache in adults. Data were pooled using a random effects approach. Among 22 randomized controlled trials, eight included a placebo comparison and 19 compared at least two active treatments. Eight studies compared TCAs to placebo, four compared TCAs to selective serotonin reuptake inhibitors (SSRIs), and two trials compared TCAs to behavioral therapies. Two trials compared tetracyclics to placebo. Single trials compared TCAs to tetracyclics, buspirone, spinal manipulation, transcutaneous electrical stimulation, massage, and intra-oral orthotics. High-quality evidence suggests that TCAs were superior to placebo in reducing headache frequency (weighted mean differences (WMD): -4.8 headaches/month, 95% CI: -6.63 to -2.95) and number of analgesic medications consumed (WMD: -21.0 doses/month, 95% CI: -38.2 to -3.8). TCAs were more effective than SSRIs. Low-quality studies suggest that TCAs are superior to buspirone, but equivalent to behavioral therapy, spinal manipulation, intra-oral orthotics, and massage. Tetracyclics were no better than placebo for chronic tension-type headache. Tricyclic antidepressants are modestly effective in reducing chronic tension-type headache and are superior to buspirone. In limited studies, tetracyclics appear to be ineffective in the prophylactic treatment of chronic tension-type headache.

Spinal rehabilitative exercise or manual treatment for the prevention of tension-type headache in adults

Spinal rehabilitative exercise or manual treatment for the prevention of tension-type headache in adults

Spinal rehabilitative exercise or manual treatment for the prevention of tension-type headache in adults.

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the short- and long-term effects of manual treatment and spinal rehabilitative exercise for the prevention of tension-type headache in adults.

Brief acupuncture not effective in the prevention of tension‐type headache

Brief acupuncture not effective in the prevention of tension‐type headache