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Review: antidepressants improve headache in patients with chronic headache

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 QUESTION: In patients with chronic headache, how effective are antidepressants?

Data sources

Studies were identified by searching Medline (1966 to December 1998), PsycLIT (1974 to December 1998), EMBASE/Excerpta Medica (1974 to December 1998), and the Cochrane Library. Bibliographies of relevant articles were reviewed, and Federal Research in Progress was searched for information on unpublished trials.

Study selection

Studies in any language were selected if they were randomised controlled trials (RCTs) comparing the effectiveness of antidepressants with placebo in patients with chronic headache and if measurable outcomes were reported.

Data extraction

Data were extracted on setting, country of origin, patient inclusion and exclusion criteria, sample size, demographical characteristics, comorbid psychiatric disease, concurrent use of analgesic medications, key components of the intervention, study quality, adverse effects, and outcomes. Outcomes were overall improvement …

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  • Source of funding: not stated.

  • For correspondence: Dr J L Jackson, Medicine-EDP, Bethesda, MD, USA. jejackson{at}