Antidepressants in the treatment of migraine headache

Punay, Nestor C; Couch, J. R.

doi:10.1007/s11916-003-0010-8

Cited by 54 publications

(32 citation statements)

References 36 publications

(30 reference statements)

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“…Tricyclic antidepressants (TCAs) are prescribed for a number of pain-related disorders, including neuropathic pain, migraine and fibromyalgia, [38][39][40] as well as…”

Section: Tricyclic Antidepressantsmentioning

confidence: 99%

Review article: modulation of the brain–gut axis as a therapeutic approach in gastrointestinal disease

Mayer¹,

Tillisch²,

Bradesi³

2006

Aliment Pharmacol Ther

121

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SummaryBackgroundThe importance of bi‐directional brain‐gut interactions in gastrointestinal illness is increasingly being recognized, most prominently in the area of functional gastrointestinal disorders. Numerous current and emerging therapies aimed at normalizing brain–gut interactions are a focus of interest, particularly for irritable bowel syndrome and functional dyspepsia.MethodsA literature search was completed for preclinical and clinical studies related to central modulation of gastrointestinal functions and published in English between 1980 and 2006.ResultsExisting data, while sparse, support the use of different classes of antidepressant drugs, including tricyclics, and selective and non‐selective serotonin reuptake inhibitors in irritable bowel syndrome. Serotonin receptor agonists and antagonists with peripheral and possibly central effects are effective in treating specific subtypes of irritable bowel syndrome. Based largely on theoretical and preclinical evidence, several novel compounds that selectively target receptors at multiple levels within the brain–gut axis such as neurokinin, somatostatin and corticotropin‐releasing factor receptor antagonists are promising.ConclusionsThis review discusses the rationale for modulation of the brain–gut axis in the treatment of functional gastrointestinal disorders and highlights the most promising current and future therapeutic strategies.

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“…Tricyclic antidepressants (TCAs) are prescribed for a number of pain-related disorders, including neuropathic pain, migraine and fibromyalgia, [38][39][40] as well as…”

Section: Tricyclic Antidepressantsmentioning

confidence: 99%

Review article: modulation of the brain–gut axis as a therapeutic approach in gastrointestinal disease

Mayer¹,

Tillisch²,

Bradesi³

2006

Aliment Pharmacol Ther

121

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“…We believe that a pharmacological treatment tailored on each patient should be always taken into account in these cases. Considering their efficacy in several headache forms [4,5] antidepressants may be the first choice.…”

Section: Discussionmentioning

confidence: 99%

Persistent orthostatic headache without intracranial hypotension: which treatment?

Curone¹,

Cecchini²,

Chiapparini³

et al. 2015

Neurol Sci

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Orthostatic headache can be the leading symptom of intracranial hypotension, however, not all orthostatic headaches are due to cerebrospinal fluid leaks and these forms can be a clinical problem, especially for treatment. Aim of this study was to review patients with persistent orthostatic headache in whom a detailed head and spinal MRI follow-up did not reveal any sign of intracranial hypotension and to evaluate which treatment can be considered the first choice. Patients admitted to our headache center for evaluation of persistent orthostatic headache and followed after first admission with clinical and neuroradiological controls were systematically reviewed. 11 patients (7 M, 4 F) followed in a period lasted from 10 months up to 2 years were studied. Six patients (54, 5 %) reported a MRI performed previously elsewhere with a suspect diagnosis of intracranial hypotension which was not confirmed at MRI at our hospital such as during the radiological follow-up. Three patients (27.2 %) had developed orthostatic headache short after a neck or head trauma with no evidence of neuroradiological pathological signs and two patients (18 %) had a previous history of psychiatric disorder. We administrated antidepressants in five patients, atypical neuroleptic in three patients, association of antidepressant and antipsychotic in one patient and muscle relaxants in two cases. All patients showed a certain improvement of headache in the weeks after introduction of the pharmacological treatment; six (54, 5 %) had pain relief during the follow-up and five (45, 5 %) were pain free at the last clinical control. We found out that patients with the best outcome were the ones treated with antidepressants. Persistent orthostatic headache without any neuroradiological sign of intracranial hypotension is a challenging problem for clinicians. Although the International Classification of Headache Disorders (ICHD-3 beta version) criteria suggests the possibility of epidural blood patch in orthostatic headache without causes, we believe that a pharmacological treatment tailored on each patient should be always considered and antidepressants can be the first choice.

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“…Antidepressants are often used to treat this condition in clinical practice [4,5]. Obsessive compulsive disorder (OCD) is mentioned among comorbid conditions in patients with CM and MO [6,7], although data are lacking as how to manage this aspect in the treatment of headache patients.…”

Section: Introductionmentioning

confidence: 99%

Outcome of patients with chronic migraine with medication overuse and depression after duloxetine: influence of coexisting obsessive compulsive disorder

Curone¹,

Tullo²,

Savino³

et al. 2013

Neurol Sci

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Patients with chronic migraine (CM) and medication overuse (MO) have high frequency of psychiatric comorbidity. Aims of this open label, prospective, independent study were: to evaluate the efficacy of duloxetine in a sample of patients with MO due to CM and with concomitant depression; to investigate, if the presence of OCD influences the outcome in this subgroup of patients. A total of 50 consecutive patients (40 F,10 M, aged 20-65 years, mean 39.4 years) from those attending our Headache Center to undergo an inpatient withdrawal programme followed by anti-migraine prophylaxis was enrolled. After a 1-month baseline period, all patients were prescribed duloxetine 30 mg in the morning for the first week, and 60 mg for the following 12 weeks. They filled a daily headache diary during the whole study period. They also completed Hamilton depression rating scale (HDRS) and migraine disability assessment scale (MIDAS) at baseline and at the 12-week follow-up. The primary outcome measure was the percentage of responders, i.e. of patients with a reduction C50 % in headache frequency as well as in symptomatic drug consumption. Comparison between patients with and without OCD was performed. Our results showed a rather high responder rate in the total sample (64 %), while none of the patients with OCD fell among responders. MIDAS and HDRS scores had a more evident decrease in patients without OSD. These findings suggest that duloxetine may be effective in patients with MO due to CM and with comorbid depression. They also confirm the importance of a systematic assessment of the psychopathological profile in these patients, and indicate that clinicians should be aware of the relevant prognostic role of OCD in favoring a poor outcome and persistent disability in headache patients with MO.

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Antidepressants in the treatment of migraine headache

Cited by 54 publications

References 36 publications

Review article: modulation of the brain–gut axis as a therapeutic approach in gastrointestinal disease

Review article: modulation of the brain–gut axis as a therapeutic approach in gastrointestinal disease

Persistent orthostatic headache without intracranial hypotension: which treatment?

Outcome of patients with chronic migraine with medication overuse and depression after duloxetine: influence of coexisting obsessive compulsive disorder

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