The doses used were 2 to 6 mg three times daily. During the past several years, when I have been faced with a patient unresponsive to tricyclics or buspirone, I have often prescribed dextroamphetamine tablets. A considerable percentage of the treated have had long-lasting lessening of headache frequency and intensity. Beginning doses are either 5 or 10 mg at breakfast and at lunch, and therapeutic doses have ranged from 10 to 80 mg daily. Although I have referred many patients to experienced, skilled psychologists with an interest in headaches, I have rarely seen patients gain sustained headache relief.
Combination therapy improves outcomes relative to monotherapy.
The researchers enrolled 203 subjects, mean age 37 years, with a diagnosis of chronic tension-type headaches. The subjects experienced a mean of 26 headache days per month. Antidepressant medication had a more rapid effect. It was not until the 6-month evaluation that the improvements in headache activity and in analgesic medication use became evident with stress management therapy.