Efficacy of Amitriptyline Versus Propranolol for prophylaxis of Migraine: A Comparative study

Abstract

Introduction: Migraine headaches may be preceded by aura symptoms lasting 4 to 72 hours; unilateral location; pulsating quality; moderate to severe intensity; aggravated by physical activity; and associations with nausea, vomiting, phonophobia or photophobia. Material and Methods: This is prospective, comparative, parallel, randomized and single centre study. This study was conducted in Medicine NC Medical College & Hospital, Israna, Panipat over a period of one year. Inclusion Criteria: Migraine patients either gender of 18 to 60 years of age according to International Headache Society Criteria for Migraine with and without Aura. Results: The mean Frequency of Attack of migraine in Amitriptyline group before treatment was 5.73±1.32 and after treatment was 3.74±0.94. In Propranolol group before treatment was 5.68±1.18 and after treatment was 4.03±0.98. There was statistically significant difference between Amitriptyline and Propranolol after treatment (p=0.023) with Unpaired t test. The mean duration of Attack of migraine Amitriptyline group before treatment was 9.37±6.74 hours and after treatment was 3.43± 0.38 hours. In Propranolol group before treatment was 9.72±6.84 hours and after treatment was 7.84±0.47 hours. There was statistically significant difference between Amitriptyline and Propranolol after treatment (p=0.029) with Unpaired t test. Conclusion: Amitriptyline is superior effective compare with propranolol but propranolol is well tolerated as compared with amitriptyline in migraine prophylaxis. The ideal drug for migraine prophylaxis is Amitriptyline, highly effective in decreasing frequency, severity and period of attack but propranolol has few side effects.