SynthesisJournal of general internal medicine2017
Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis.
Synthesis in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Comparative effects of pharmacological interventions in the prophylactic treatment of tension-type headache: systematic review and network meta-analysis.Annals of medicine · 2026Pooled it
- Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison meta-analysis.The journal of headache and pain · 2024Pooled it
- Biomarkers and Breakdowns: Neuroinflammatory Drivers Linking Sleep Disorders and Chronic Pain.Biomedicines · 2026Review
- Article
- Hallmarks of primary headache: part 2- Tension-type headache.The journal of headache and pain · 2025Review
- Ginsenoside Rg1: A Neuroprotective Natural Dammarane-Type Triterpenoid Saponin With Anti-Depressive Properties.CNS neuroscience & therapeutics · 2024Review
- Structure-activity relationship of pharmacophores and toxicophores: the need for clinical strategy.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2024Review
- Efficacy and safety of the Chaixiong Qiwei granule for tension-type headache: study protocol for a randomised controlled trial.BMJ open · 2023Article
- Gut-Brain Crosstalk and the Central Mechanisms of Orofacial Pain.Brain sciences · 2023Review
- Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress.BMC medicine · 2023Review
- Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews.BMJ (Clinical research ed.) · 2023Review
- Clinical-Epidemiology of Tension-Type Headache among the Medical and Dental Undergraduates of King Khalid University, Abha, Saudi Arabia.Journal of personalized medicine · 2022Article
- Tips for Busy Clinicians to Gauge Conclusions from Clinical Trials.Journal of general internal medicine · 2022Article
- Are Psychotropic Medications Effective in Chronic Pain Management in Children and Adolescents? A Meta-Analysis of Randomized Control Trials.Journal of pain research · 2021Article
- The Association Between Blood Pressure and Headache in Postmenopausal Women: A Prospective Hospital-Based Study.International journal of general medicine · 2021Article
- [Tension type headaches : Quo vadis?]Schmerz (Berlin, Germany) · 2020Review
- Chinese Herbal Formula Xuefu Zhuyu for Tension-Type Headache withEvidence-based complementary and alternative medicine : eCAM · 2020Article
- Emerging Novel Pharmacological Non-opioid Therapies in Headache Management: a Comprehensive Review.Current pain and headache reports · 2019Review
- Local Anesthetic Effect of Amitriptyline versus Lidocaine in Isolated Lesion of the Limb Requiring Primary Suturing; Assessing a Novel Therapeutic Agent.Bulletin of emergency and trauma · 2019Article
- Antidepressants for Preventive Treatment of Migraine.Current treatment options in neurology · 2019Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTension-type headaches are a common source of pain and suffering. Our purpose was to assess the efficacy of tricyclic (TCA) and tetracyclic antidepressants in the prophylactic treatment of tension-type headache.
methodsWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, the ISI Web of Science, and clinical trial registries through 11 March 2017 for randomized controlled studies of TCA or tetracyclic antidepressants in the prevention of tension-type headache in adults. Data were pooled using a random effects approach. KEY
resultsAmong 22 randomized controlled trials, eight included a placebo comparison and 19 compared at least two active treatments. Eight studies compared TCAs to placebo, four compared TCAs to selective serotonin reuptake inhibitors (SSRIs), and two trials compared TCAs to behavioral therapies. Two trials compared tetracyclics to placebo. Single trials compared TCAs to tetracyclics, buspirone, spinal manipulation, transcutaneous electrical stimulation, massage, and intra-oral orthotics. High-quality evidence suggests that TCAs were superior to placebo in reducing headache frequency (weighted mean differences (WMD): -4.8 headaches/month, 95% CI: -6.63 to -2.95) and number of analgesic medications consumed (WMD: -21.0 doses/month, 95% CI: -38.2 to -3.8). TCAs were more effective than SSRIs. Low-quality studies suggest that TCAs are superior to buspirone, but equivalent to behavioral therapy, spinal manipulation, intra-oral orthotics, and massage. Tetracyclics were no better than placebo for chronic tension-type headache.
conclusionsTricyclic antidepressants are modestly effective in reducing chronic tension-type headache and are superior to buspirone. In limited studies, tetracyclics appear to be ineffective in the prophylactic treatment of chronic tension-type headache.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.