Is Amitriptyline better for tension-type headaches?

Question

Hi doctor,

I had a mild balance problem while walking, a month and a half back. I did not have vomiting or nausea. I was put on Betahistine and B-Citam for 30 days, which cured 99 % of my balance problem. But, I felt dizzy the whole day. I also have a mild difficulty in swallowing, so I consulted a neurologist. He gave me Stugeron and Betahistine 24 mg, for 20 days. Today after 20 days, 90 % dizziness is gone, and I do not have the balance problem. But I still feel little dizzy, and I have tension-type headaches over my scalp. I am not taking any medicines for this headaches. Please suggest some medicine for tension type headache (TTH). The doctor gave me Flunarizine and Propylamine hydrochloride, but I still have the balance problem. All my other blood reports are normal. My hemoglobin, lipid, troponin, fibrinogen, magnetic resonance imaging (MRI), and angiography are all normal. What should I do? Should I continue my prescribed medicines? Is Amitriptyline better for TTH? Please help.

Answer 1

Hi,

Welcome to icliniq.com. I read your query with keen interest and understand your concerns. While considering your symptoms in totality and reviewing diagnosis made by other doctors in the past, I feel a fair trial of low dose Amitriptyline should be given. Most of my patients with similar presenting complaints, report good improvement in tension-type headaches and vertigo to 25 mg of Amitriptyline at bedtime. It is not possible to say which medicine is better without personally seeing the patient, but I think Amitriptyline will make a better option. At the same time, I am of the opinion that a single medicine for vertigo should be tried first before trying multiple medications. As I can see in your description, you are taking both Cinnarizine (Stugeron) and Betahistine. In my opinion,removing Stugeron should help you in decreasing the dizziness. I hope this answers you. Feel free to contact me if you have more questions. Thanks and regards.