What is the role of antidepressants in migraine prevention?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Tricyclic antidepressants are good second-line alternatives because of their adverse-effect profile and efficacy. Head-to-head comparisons of agents in this class have not been conducted, but amitriptyline and nortriptyline are commonly used.

Although selective serotonin reuptake inhibitors (SSRIs) are widely used, data regarding their efficacy in migraine prevention are lacking; consequently, SSRIs are not recommended for migraine prevention. However, limited data do support the use of serotonin/norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta) and venlafaxine (Effexor) for migraine prevention.


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