Pharmacological treatments used for migraine prevention and psychiatric comorbidities
| Treatment | Psychiatric comorbidity use | Migraine prevention effectiveness |
|---|---|---|
| Tricyclic antidepressants (TCAs), eg, amitriptyline | Effective for depression at high doses, with more side effects | Effective for migraine prevention at low doses, with minimal side effects |
| Serotonin-Neuropinephrine Reuptake Inhibitors (SNRIs), eg, venlafaxine | Effective for depression and decreases anxiety | Only venlafaxine has grade B evidence of efficacy for migraine prevention144 However, the most recent Cochrane study did not find venlafaxine to be more effective than placebo for prevention of chronic migraines145 |
| Selective Serotonin Reuptake Inhibitors (SSRIs), eg, fluoxetine | Effective for depression | According to the Cochrane review, SSRIs were not better than placebo for migraine prevention145 |
| β-blockers, eg, propranolol | Might help with anxiety, but might also worsen depression | Effective for migraine prevention |
| Anticonvulsants | ||
| Topiramate | Might help with mood stabilisation, but might also worsen depression | Effective for migraine prevention |
| Divalproex sodium | Might help with mood stabilisation, bipolar disorder | Effective for migraine prevention |