Pharmacological treatment compared to behavioural treatment for juvenile tension-type headache: results at two-year follow-up.

Recurrent headaches are common in children and adolescents. Most current investigations have employed limited modalities (either medication or behavioural) and few have included comparisons of different treatments. In this study relaxation training, administered in a limited contact format, and amitriptyline were compared for juvenile episodic tension-type headache. The clinical improvement was significant for both groups at 1- and 2-year follow-up; in particular for behavioural treatment, the patients came regularly for the sessions, practised routinely, and appeared to be compliant and accepting of treatment, although we did not assess this formally. In this group of patients the percentage of drop-outs was lower than in the pharmacological tratment. Although clinical results were similar in both groups, relaxation therapy seems to be more accepted than medication. The limited contact modality seems to be as useful as other behavioural approaches that require a greater investment of time (by patients and therapists), without unpleasant side effects. Because the sample sizes are small, these conclusions are tentative.