[The treatment of migraine and tension headaches with amitriptyline (author's transl)]. / Le traitement des migraines et des céphalées psychogènes par l'amitriptyline.

Study of 100 patients followed up for over one year, including 26 cases of migraine (4 classical migraine) and 74 cases of tension headache associated or not with muscular tension. With dihydroergotamin alone 16 cases of migraine, and with amitriptyline alone 17 cases experienced excellent to fair relief, while with the association of both drugs, 21 excellent results were obtained. Among tension headaches patients, 53 were relieved with amitriptyline alone, 56 when DHE was added. The activity of amitriptyline in lower dosages is very likely not an anti-depressant one, but connected with catecholamines metabolism. Dosage must be adjusted in each individual case. The efficiency of DHE in tension headaches suggest a possible part of vaso-motor mechanisms in such cases.

[Headaches, migraine and oral contraception].

PIP: Reports of migraines and headaches in users of oral contraceptives usually range from less than 1 to 20%, except higher in the 1st cycle, in papers on oral contraceptive trials, and about 30% of series of migraine patients in papers by headache specialists. Headaches usually occur within 1-3 days after a cycle of pills is stopped. Etiologic factors include the progestagen in the pill, possibly the estrogen, perhaps prolactin; and prostaglandins and water retention have been suggested causes. The author saw 4 cases of headaches in women that developed hypertension of 160-170/100-105 when they started the pill. Migraines can be treated with the usual medications, and psychogenic headaches with tranquilizers, antidepressives, or psychotherapy.^ieng