Comparative assessment of nortriptyline and venlafaxine on psychomotor performances in patients with tension-type headache: A parallel, open-label, prospective, observational study

Abstract CONTEXT: Prophylaxis of tension-type headache (TTH) routinely involves tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors, and serotonin norepinephrine reuptake inhibitors (SNRIs). The psychomotor ability of a patient can be affected by these drugs, and knowing the effects of these drugs on the same can help us select the suitable drug for TTH patients without affecting their daily activities. AIMS AND OBJECTIVES: The aim of our study was to compare the effect of nortriptyline (a TCA) and venlafaxine (an SNRI) on psychomotor performances in patients with TTH. METHODOLOGY: Twenty-four patients who were diagnosed with TTH by the treating psychiatrist were assessed in the study. Psychomotor performances of these patients were evaluated using the critical flicker fusion test, and the hand steadiness test (HST). Adherence to treatment was determined at the end of the 8 th week using the medication adherence rating scale. RESULTS: At the end of 8 weeks, venlafaxine significantly reduced critical flicker frequency (CFF) to that of nortriptyline ( P = 0.0004). The HST scores were insignificant between groups at the end of the study. Nortriptyline and venlafaxine both improved hand steadiness significantly ( P = 0.001 in both groups) at the end of our study. Adherence to medication was similar in both groups. CONCLUSION: Our study concludes that nortriptyline is better and does not affect the central integration of study subjects. Both the drugs in our study have been shown to improve the fine motor function in patients with TTH.