Does amitriptyline prophylaxis decrease the frequency of migraines?

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Yes, by most measures. Amitriptyline leads to large reductions in the frequency of migraines compared with placebo over 24 weeks (SOR: B, meta-analysis of conflicting RCTs). Amitriptyline leads to 1 less migraine per month compared with placebo at 12 weeks and about twice as many patients reporting a 50% reduction in headache days (SOR: B, RCT).

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