Reviewed By: Pramod Kerkar, MD, FFARCSI

Migraine is an annoying condition that can leave you completely exhausted. While there are various causes of migraine, stress is also one of the important trigger factors. A lot has been discussed about migraine home remedies and over-the-counter as well as prescription medicines. But this article focusses on a different approach in treating migraine with antidepressant. Are antidepressants the new treatment for migraine? Let us understand this standpoint in detail.

Can Antidepressants Treat Migraine?

Antidepressants are the drugs used for treating depression and its associated symptoms. Some of these antidepressants are found to be effective in the treatment of a migraine, and even prevent migraine headaches in some cases. However, this only holds true for people who do not suffer from depression in the first place. There are many different types of antidepressants available today and all of them work by altering a neurotransmitter and affecting the different chemical pathways found in the brain. Neurotransmitters are chemicals responsible for carrying messages between the brain cells. People with a migraine can benefit further from using antidepressants for their headaches as migraine patients are known to be five times more likely to also suffer from anxiety and depression. Some of these antidepressants may also help migraine patients who have trouble sleeping. So how do antidepressants help migraine patients and are they the new treatment for a migraine?

Types of Antidepressants

In the process of understanding whether antidepressants are the new treatment for migraine, it is necessary to understand how antidepressants work. Their action can be related to the causes and trigger factors, which can help in associating the role of antidepressants in preventing and treating migraine headaches. It is important to first understand the various types of antidepressants that are available on the market today. Primarily, there are four major types of antidepressants. These include:

  • Selective Serotonin Reuptake Inhibitors (SSRIs) - This is the most commonly prescribed antidepressants as they are known to have fairly less side effects. SSRIs work in the body by increasing the level of serotonin, a neurotransmitter, in the brain. Serotonin is also referred to as the 'happy' hormone, and an increase in their levels, makes a person feel less depressed.
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) - The second most commonly prescribed antidepressant type, SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain.
  • Monoamine Oxidase Inhibitors (MAOIs) - MAOIs function by blocking the enzyme known as monoamine oxidase. Monoamine oxidase is created naturally in the body to destroy monoamines such as dopamine, serotonin, and norepinephrine, thus causing a person to slip into depression. By blocking this particular enzyme, MAOIs prevent the monoamines from getting destroyed. These antidepressants are rarely prescribed as they have a lot of serious side effects.
  • Tricyclic Antidepressants - Also known as cyclic antidepressants, these drugs also work similar to SNRIs and increase the levels of serotonin and norepinephrine in the brain.

How do Antidepressants Prevent Migraines?

Most experts remain divided over the causes of a migraine. In fact, no one is really sure as to what causes migraines. It is believed by researchers at the Mayo Clinic that an imbalance of certain neurotransmitters in the brain may have a role to play. It has also been observed that when a person experiences migraine, their serotonin levels drop. This is probably the reason why antidepressants seem to work effectively in the prevention of migraines.

For the answer to the question, are antidepressants the new treatment for migraine, it is important to know that migraine treatment consists of two parts. One is treating active migraine headache and associated symptoms and the other is long term medicine for prevention of migraine. Antidepressants work mainly on the migraine prevention side such that it can reduce migraine episodes over time.

For prevention of migraines, doctors commonly opted to prescribe tricyclic antidepressants till now. However, a new study done in 2017 at the Chongqing Key Laboratory of Neurobiology, has found evidence that even SSRIs and SNRIs are also equally effective at preventing migraines. This finding is of particular importance because SSRIs and SNRIs are preferred over tricyclic antidepressants since they cause lesser side effects. This is also more important considering the fact that people suffering from migraine are more sensitive and can also be more prone to gastric upsets and other side effects of medicines. Hence, there is a need to use medicines that cause lesser side effects and antidepressants that are more efficacious and cause less side effects.

In spite of many promising studies, experts, nevertheless, still note that there is still a requirement of more controlled and large-scale studies to understand just how antidepressants help prevent migraines. While this continues, migraine need to follow a healthy routine, practice regular exercises and relaxation, follow a balanced diet and drink plenty of water.

Conclusion

If you suffer from regular migraines and you have not had any success with your ongoing treatments, then it is worth taking a medical opinion whether or not you can try taking antidepressants. It is important to understand, though, that antidepressants cannot treat an active migraine headache. They can only be used for preventing migraines.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: August 17, 2018

This article does not provide medical advice. See disclaimer

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