Antidepressants for Migraine Headaches

Topic Overview

Antidepressant medicines, 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.

Tricyclic antidepressants are used most to prevent migraines. Amitriptyline and nortriptyline are used most often.

Other antidepressants may be tried if you do not respond well to amitriptyline or nortriptyline. The choice of antidepressant to treat your migraines may depend on your ability to tolerate the side effects of the medicine.

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.

Never suddenly stop taking antidepressants. The use of any antidepressant should be tapered off slowly and only under the supervision of a doctor. Abruptly stopping antidepressant medicine can cause negative side effects or a relapse into a depressive episode or panic disorder.

FDA advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
• A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.