From: Aids to management of headache disorders in primary care (2nd edition)
Amitriptyline, 10–100 mg at night | • Drug of choice for frequent episodic or chronic TTH; • Intolerance is reduced by starting at a low dose (10 mg) and incrementing by 10–25 mg each 1–2 weeks |
Nortriptyline (replacing amitriptyline at the same dose) | • Fewer anticholinergic side-effects but less good evidence of efficacy |
Mirtazapine, 15–30 mg once daily | • Second-line option |
Venlafaxine, 75–150 mg once daily | • Third-line option |