Antidepressant medications, which are usually used to treat
depression, can be effective in preventing migraine
headaches. Antidepressants have some pain-relieving properties and may reduce
duration and frequency of headaches. Antidepressants are also used to improve
sleep problems.
Antidepressants that are used to prevent migraines include:
- Tricyclic antidepressants.
- Monoamine
oxidase inhibitors (MAOIs).
Amitriptyline, a tricyclic antidepressant, has been shown to be
effective in preventing
migraines.1 Other tricyclic
antidepressants may be tried if you do not respond well to amitriptyline,
although the evidence to support their effectiveness varies.
The choice of antidepressant to treat your migraines may depend on
your ability to tolerate the side effects of the medication.
Side effects of tricyclic antidepressants include:
- Dry
mouth.
- Constipation.
- Blurred
vision.
- Inability to urinate.
- Weight
gain.
- Low blood pressure when you stand up
quickly.
- Sleepiness.
Side effects of MAOIs include:
- Difficulty getting to
sleep.
- Dizziness, lightheadedness, and fainting.
- Dry
mouth.
- Blurred vision.
- Appetite
changes.
- High blood pressure.
- Changes in heart rate and
rhythm.
- Muscle twitching and feelings of
restlessness.
- Loss of sexual desire or ability.
- Weight
gain.
- Negative interactions with other medications and some
foods.
You must also avoid certain foods that contain tyramine when you are
taking an MAOI to avoid harmful interactions. Examples of foods to avoid
include:
- Chocolate.
- Alcohol.
- Aged,
canned, cured, or processed meat.
- Aged cheeses, such as blue,
cheddar, and mozzarella.
- Food that contains monosodium glutamate
(MSG).
FDA Advisories
The U.S. Food and Drug Administration (FDA) has issued an
advisory on antidepressant medicines and the risk of
suicide. The FDA does not recommend that people stop using these medicines.
Instead, a person taking antidepressants should be watched for
warning signs of suicide. This is especially important
at the beginning of treatment or when the doses are changed.
The FDA has also issued a warning about taking SSRIs or SNRIs (two
kinds of antidepressant medicines) with triptans (used for migraines). Taking
these medicines together can cause a very rare but serious condition called
serotonin syndrome.