What is a migraine? Why migraine happens. Who gets migraines? Treating migraines.

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


Dry mouth


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


Drug and food interactions

Dry mouth


High blood pressure


Loss of libido

Muscle spasms


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



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.