Prediction of Migraine Prevention Efficacy Based on Individual's Pain Modulation
Status:
Completed
Trial end date:
2016-02-01
Target enrollment:
Participant gender:
Summary
A major reason for the substantial underuse of pharmacological prevention of migraine is its
inadequate efficacy, since only ~50% of patients respond to a specific agent. There is
currently no evidence-based way to identify the patients that will respond to a specific
preventive treatment. Amitriptyline is one of the commonest agents used for migraine
prevention, strengthening patient's pain inhibitory capacity. Individual tailoring of
analgesics according to pain inhibitory capacity has been shown effective by our group for
painful diabetic neuropathy patients. Specifically, patients with reduced pain inhibition
capacity gained more from a drug that augment pain inhibition as compared to those with
efficient inhibitory capacity. The investigators now propose to assess migraineurs for their
pain inhibition capacity, and examine whether, along similar reasoning, those with reduced
inhibitory capacity are the ones more likely to respond to amitriptyline. Psychophysical and
neurophysiological dimensions of pain inhibitory modulation will be assessed in migraineurs,
who will, subsequently, receive either amitriptyline or placebo for 8 weeks, in a randomized
two arms parallel double blind design, and followed up for attacks reduction. The
investigators expect to identify the best predictors for efficacy of migraine prevention by
the study drug. This approach will promote individualization of migraine therapy.
Phase:
N/A
Details
Lead Sponsor:
Rambam Health Care Campus
Collaborator:
Migraine Research Foundation
Treatments:
Amitriptyline Amitriptyline, perphenazine drug combination