Migren merupakan penyebab tersering nyeri kepala berulang pada

ABSTRAK
Latar belakang: Migren merupakan penyebab tersering nyeri kepala
berulang pada anak dan remaja. Efikasi amitriptilin sebagai terapi preventif
nyeri kepala migren telah luas berkembang pada dewasa, sedangkan
pemakaiannya pada anak dan remaja masih memiliki keterbatasan data.
Tujuan: Menilai efikasi amitriptilin sebagai terapi preventif serangan nyeri
kepala migren pada remaja.
Metode: Suatu penelitian uji klinis acak tersamar tunggal dilakukan di Medan,
Sumatera Utara antara bulan Juli hingga Oktober 2009. Penderita yang
memenuhi kriteria migren sesuai dengan The International Headache Society
(IHS) dimasukkan dalam penelitian. Partisipan dibagi atas dua grup yaitu
grup amitriptilin yang mendapat 10 mg amitriptilin atau grup plasebo selama 3
bulan. Frekuensi nyeri kepala dinilai dalam hari per bulan, durasi dinilai dalam
jam dan disabilitas fungsi dinilai dengan menggunakan Pediatric Migraine
Disability Assessment Scale (PedMIDAS). Efikasi pengobatan dinilai
sebelum, selama dan setelah pengobatan.
Hasil: Sebanyak 98 orang remaja mengikuti penelitian dengan rentang usia
12 hingga 19 tahun (rerata 14.69 tahun), dan dibagi atas dua kelompok.
Dibandingkan sebelum pengobatan, terdapat perbedaan yang bermakna
pada frekuensi nyeri kepala dan skor PedMIDAS pada kelompok amitriptilin
(P=0.001, IK 95% (2.023;2.937) dan P=0.001, IK 95% (7.664;9.756), tetapi
tidak pada kelompok plasebo. (P>0.05). Terdapat perbedaan yang bermakna
pada frekuensi, durasi dan disabilitas fungsi pada kelompok amitriptilin
dibandingkan plasebo setelah 3 bulan.( P< 0.05).
Kesimpulan: Amitriptilin efektif sebagai terapi preventif serangan nyeri
kepala migren pada remaja setelah pengobatan selama 3 bulan.
Kata kunci: Amitriptilin, preventif, migren, remaja
16
ABSTRACT
Background: Migraine is a cause of recurrent headache in childhood. The
efficacy of amitriptyline is well known as a prophylactic treatment in adults,
whereas in children and adolescents do not have sufficient data.
Objective: To determine the efficacy of amitriptyline as the prophylactic
treatment of migraine in adolescents.
Methods: We conduct a single-blind randomized controlled trial in Medan,
North Sumatra, from July until October 2009. Participants eligible for migraine
according to International Headache Society criteria were included in the
study. They were divided into two groups, each group was given 10 mg of
amitriptyline or placebo for 3 months. Headache frequency was measured in
headache days per month, duration was measured in hours and functional
disability was measured by Pediatric Migraine Disability Assessment Scale
(PedMIDAS). The efficacy was measured before, during and after
intervention.
Results: A total of 98 patients, ranging in age from 12 until19 years (mean
age 14.69 years) were enrolled to the study, and divided into amitriptyline and
placebo groups. Compared to baseline, there were significant difference on
headache frequency and PedMIDAS score in amitriptyline group (P=0.001,
95%CI (2.023;2.937) and P=0.001, 95%CI (7.664;9.756), but not in placebo
group (P>0.05). There were significant differences on frequency, duration,
and functional disability in amitriptyline groups compared to placebo after 3
months of treatment (P< 0.05).
Conclusion: Amitriptyline appears to be effective in prophylactic treatment of
migraine in adolescent after 3 months of intervention.
Key words: Amitriptyline, prophylaxis, migraine, adolescents
17