Which medication is used for prevention of tension-type headaches?

Which medication is used for prevention of tension-type headaches?

• A. Topiramate
• B. Gabapentin
• C. SNRIs may be effective without depression
• D. Amitriptyline

Answer: (D)

Low-dose amitriptyline is the most effective option for preventing tension-type headaches because it modulates central pain pathways and often improves sleep, addressing two key features of chronic tension-type headaches: persistent pain and sleep disturbance. As a tricyclic antidepressant, it reduces pain signaling and can lessen attack frequency, intensity, and duration when used prophylactically at low doses (often 10–25 mg at night). It has the best-supported prophylactic evidence for tension-type headaches among commonly considered options. Topiramate and gabapentin are more commonly used for migraine prevention and neuropathic-related pain, with less robust or consistent evidence for tension-type headache prevention. SNRIs refer to a class of drugs rather than a specific preventive agent, and while some may help certain headache patients, they are not established as the standard first-line preventive for tension-type headaches.

Low-dose amitriptyline is the most effective option for preventing tension-type headaches because it modulates central pain pathways and often improves sleep, addressing two key features of chronic tension-type headaches: persistent pain and sleep disturbance. As a tricyclic antidepressant, it reduces pain signaling and can lessen attack frequency, intensity, and duration when used prophylactically at low doses (often 10–25 mg at night). It has the best-supported prophylactic evidence for tension-type headaches among commonly considered options.

Topiramate and gabapentin are more commonly used for migraine prevention and neuropathic-related pain, with less robust or consistent evidence for tension-type headache prevention. SNRIs refer to a class of drugs rather than a specific preventive agent, and while some may help certain headache patients, they are not established as the standard first-line preventive for tension-type headaches.