Kronik Gerilim Tipi Baş Ağrısı Profilaksisinde Amitriptilin ve Essitolopramın Karşılaştırılması

Amaç: Kronik gerilim tipi baş ağrısının profilaktik tedavisinde amitriptilin ve essitalopram kullanımının ağrı skorlaması, ağrılı gün sayısı ve ağrı kesici kullanımı üzerine etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Kronik gerilim tipi baş ağrısı tanılı 51 amitriptilin ve 42 essitalopram profilaksisi alan toplam 93 hasta çalışmaya alındı. Depresyon ekarte edilen hastalar, 3 aylık profilaksi sonucunda ağrı skorlamalarında, ağrılı gün sayılarında ve ağrı kesici kullanım sayılarındaki değişimler yönünden karşılaştırıldı. Bulgular: Amitriptilin essitalopramla kıyaslandığında vizüel analog skala skorlamasında ve 3 aylık Hamilton depresyon ölçeği skorlamasında anlamlı fark yaratmıştır (p=0,027 ve p=0,007). Ağrılı gün sayısı ve ağrı kesici kullanım sıklığı açısından iki grup arasında anlamlı fark bulunmadı (p=0,229 ve p=0,672). Sonuç: Kronik gerilim tipi baş ağrısı toplumda en fazla görülen baş ağrısı tipidir. Profilaktik tedavisinde ilk seçenek amitriptilin olmakla birlikte geniş yan tesir profili ve yaşlılar gibi özellikli gruplarda kullanım kısıtlılıkları sebebiyle alternatif ajanlara ihtiyaç vardır. Bu çalışmada essitalopramın toplumumuzda profilaktik olarak kullanılma ihtimalini ortaya koymuştur.

Anahtar Kelimeler:

Amitriptilin, Essitalopram, Gerilim Tipi Baş Ağrısı, Profilaksi

Comparison of Amitriptyline and Escitalopram in Tension-Type Headache Prophylaxis

Aim: We aimed to compare the effects of amitriptyline and escitalopram use in the prophylactic treatment of chronic tension-type headache on pain scoring, number of painful days, and painkiller use. Material and Method: A total of 93 patients diagnosed with chronic tension-type headache, 51 receiving amitriptyline and 42 receiving escitalopram prophylaxis, were included in the study. Patients in whom depression was ruled out were compared in terms of changes in pain scores, number of days with pain, and number of painkillers used as a result of 3-month prophylaxis. Results: Amitriptyline caused a statistically significant difference in visual analogue scale scoring and 3-month Hamilton depression scale scoring when compared to escitalopram (p=0.027 and p=0.007). There was no significant difference between the two groups in terms of the number of painful days and the frequency of painkiller use (p=0.229 and p=0.672). Conclusion: Chronic tension-type headache is the most common type of headache in society. Although amitriptyline is the first choice in prophylactic treatment, alternative agents are needed due to its wide side effect profile and limitations in use in special groups such as the elderly. This study revealed the possibility of using escitalopram prophylactically in our society.

Keywords:

Amitriptyline, Escitalopram, Tension-Type Headache, Prophylaxis,

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