Table 11.

Drugs for the preventive treatment of tension-type headache with a level of recommendation I and II

Drug	Dosage (mg)	Level of evidence	Scientific strength of evidence	Clinical effectiveness	Adverse events	Level of recommendation	Comments
Antidepressants
Amitriptyline	25–75	A	+++	+++	Frequent, not severe	I	Useful in patients with comorbid anxiety, depression, insomnia. Contraindicated in the case of glaucoma and prostatic hypertrophy
Clomipramine	10–150	B	++	++	Frequent, not severe	II
Fluvoxamine	50–100	B	++	++	Frequent, not severe	II
Maprotilin	75	B	+++	++	Frequent, not severe	II
Mianserin	30–60	A	++	+	Frequent, not severe	II
Mirtazapine	15–30	A	+++	+++	Frequent, not severe	I	Particularly indicated in patients with anxiety, depression, insomnia. It may induce somnolence
Venlafaxine	75–150	B	++	++	Frequent, not severe	II
Muscle relaxants
Tizanidine oral	3–12	B	+++	+++	Frequent, not severe	II	Especially useful in the case of pericranial muscle tenderness
Benzodiazepines
Diazepam	5	B	++	++	Occasional, not severe	II
Other drugs
Topiramate oral	25–100	C	+++	+++	Frequent, not severe. Rarely severe	II