For chronic tension-type headaches, which medication may reduce headache duration and severity?

For chronic tension-type headaches, which medication may reduce headache duration and severity?

• A. Amitriptyline
• B. Propranolol
• C. Sumatriptan
• D. Topiramate

Answer: (A)

Chronic tension-type headaches respond well to preventive therapy with a low-dose tricyclic antidepressant. Amitriptyline, given in small nightly doses, can reduce how long each headache lasts and how severe it is. This effect likely comes from dampening central pain processing and improving sleep, which helps lower overall headache burden. The other drugs listed are more aligned with migraine treatment. Propranolol can help some migraine preventions but is not as effective for tension-type headaches. Sumatriptan treats acute migraine attacks, not chronic tension-type headaches. Topiramate can be used for migraine prevention but has less consistent evidence for CTTH.

Chronic tension-type headaches respond well to preventive therapy with a low-dose tricyclic antidepressant. Amitriptyline, given in small nightly doses, can reduce how long each headache lasts and how severe it is. This effect likely comes from dampening central pain processing and improving sleep, which helps lower overall headache burden.

The other drugs listed are more aligned with migraine treatment. Propranolol can help some migraine preventions but is not as effective for tension-type headaches. Sumatriptan treats acute migraine attacks, not chronic tension-type headaches. Topiramate can be used for migraine prevention but has less consistent evidence for CTTH.