Pediatric Chronic Headache Trial

Inclusion Criteria: * diagnosis of chronic daily headache based on definition of 15 or more headache days per month measured by a prospective daily headache diary * females or males between the ages of 10-17 * PedMIDAS Disability Score \> 20, indicating at least moderate disruption in daily activities Exclusion Criteria: * medication overuse as defined in the ICHD-II criteria (NSAID or other simple analgesic on ≥ 15 days/ month for \>3 months; triptan intake in any formulation ≥ 10 days/month on a regular basis of ≥ 3 months) * current treatment with amitriptyline * no other current prophylactic antimigraine medication within a period equivalent to \< 5 half-lives of that medication before entering the screening phase * other chronic pain condition such as juvenile primary fibromyalgia syndrome, complex regional pain syndrome-II * abnormal findings on EKG * current or past history of severe orthostatic intolerance or severe levels of orthostatic dysregulation (orthostatic hypotension or postural orthostatic tachycardia syndrome) * significant documented developmental delay or impairments such as autism, cerebral palsy or mental retardation * present or lifetime psychiatric diagnosis that meets DSM-IV criteria for bipolar disorder, major depressive disorder or psychosis * PedMIDAS Disability Score of \> 140, indicating need for multi-systemic therapies to address very significant level of disability * youth who are pregnant, or those females who are sexually active and not using a medically accepted form of contraception (barrier or hormonal methods) or do not agree to be abstinent during the study * disallowed medications/products: opioids, antipsychotics, antimanics, barbiturates, benzodiazepines, muscle relaxants, sedatives, tramadol