Be Happy, Be Migraine-Free
Certain medications used to treat depression have been found to be effective as preventative treatments for migraine headaches. Since antidepressants do have some pain relieving properties, these medications may also reduce the duration and frequency of headaches.
Antidepressants that have been found to be effective as treatments for migraine headaches include tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
Amitriptyline (Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant that has been shown to be an effective preventative treatment for all types of headaches, including migraines. This medication reduces migraines by affecting the levels of serotonin and other brain chemicals. While other tricyclic antidepressants have been found to be of less value in treating migraines (Pamelor, Vivactil), some patients not responding to amitriptyline have tried them with varying results. Many patients find the side effects of these medications too difficult to tolerate.
Side effects of tricyclic antidepressants include:
Blurred vision
Constipation
Dry mouth
Fatigue
Low blood pressure on standing
Urine retention
Weight Gain
Common MAOIs include Aurorix, Eldepryl, Emsam, Iporzid, Ipronid,
Iproclozide, Manerix, Marplan, Marsilid, Moclodura, Nardil, Parnate,
Propilniazida, Rivivol, Selegiline, and Toloxatone.
Children under the age of 16 should avoid the use of MAOIs due to the increased risk of adverse reactions. Animal studies suggest that MAOIs may retard growth in children. The elderly tend to experience dizziness or lightheadedness when treated with this class of medication. Because of the possibility that MAOIs may cause a sudden increase in blood pressure, or hypertensive crisis, MAO inhibitors are not often prescribed to people over 60, or those with cardiovascular disease.
Side effects of MAOIs include:
Blurred vision
Changes in appetite
Changes in heart rate and rhythm
Dizziness
Drug and food interactions
Dry mouth
Fainting
High blood pressure
Insomnia
Loss of libido
Muscle spasms
Restlessness
Weight gain
No Chocolate???
Foods and additives containing tyramine must be avoided during treatment with MAOI to avoid dangerous interactions. Food and additives containing tyramines include:
Aged cheese
Aged, canned, cured, or processed meats
Alcohol
Chocolate
Monosodium glutamate (MSG)
Suicide Watch
There is an FDA advisory on the relationship between the use of antidepressants and suicide. The FDA advises that patients being treated with these medications should be watched for warning signs of suicide, and the risk is greatest at the beginning of treatment or after dosage adjustments.
A further FDA advisory relates to the possible interaction between SSRIs and SNRIs (both antidepressants) with triptans (migraine medication). The combination of these medications may lead to a rare and serious condition called serotonin syndrome.
Newer antidepressants are less effective for migraine prevention. There is no real evidence that Zoloft, an SSRI works to prevent migraines.
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