Efficacy and safety of the following antidepressants: amitryptiline (tricyclic antidepressant), escitalopram (selective inhibitor of serotonin reuptake), milnacipran (selective inhibitor of serotonin and noradrenalin reuptake) and maprotiline (selective inhibitor of noradrenalin reuptake) have been compared during the treatment of 120 patients with chronic daily headache. A positive effect was found for all drugs, in particular in the presence of depressive and anxiety symptoms. Most effective proved to be milnacipran and amitryptiline. Escitalopram and milnacipran were more tolerable and had less side-effects. The authors suggested that the combination of noradrenergic and serotoninergic components appears to be most effective in treatment of chronic daily headache.
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