Antidepressants

Antidepressants: Quick Look

UsePrevent migraine or reduce the severity of attacks
EffectivenessProbable efficacy for amitriptyline, venlafaxine1
Migraine-specific?No
Prescription?Yes
Side effectsAmitriptyline: Frequent and numerous side effects2
Venlafaxine: Occasional, especially nausea and vomiting2
Taken how?Tablet
Drugs in this class
Brand Name(s)Generic Name
Amitid*, Amitril*, Elavil*, Endep*amitriptyline
Aventyl, Pamelornortriptyline
Effexor*venlafaxine
Cymbalta, Irenkaduloxetine
Prozac, Rapiflux, Selfemra, Sarafemfluoxetine

*Brand name product has been discontinued, but the drug is still available in generic form.

Antidepressants are drugs that are mainly used for treating mental health conditions like depression. However, there is evidence that antidepressants can help treat migraine. Some doctors may prescribe antidepressants for someone who has migraine, even if they do not have mental health issues.1

How do antidepressants help treat migraine?

Antidepressants may be used to prevent migraines or lower their severity. In fact, certain types of antidepressants were some of the first drugs used to treat migraines. It is now less common to use antidepressants for treating migraines. This is because antidepressants may cause noticeable and unpleasant side effects.1,2

Antidepressants work by targeting certain chemicals in the brain. They may target serotonin, norepinephrine, or both. Serotonin and norepinephrine play a role in mood. They also have a role in pain. This may be the reason that antidepressants can reduce the frequency or severity of migraines.1,2

There are medicines that work better than antidepressants for migraine prevention. However, antidepressants could be a good option if you have migraine and depression, anxiety, or trouble sleeping.1,2

Examples of antidepressants for migraine

There are different classes of antidepressants that may be used to treat migraine. The most common is a type of drug called tricyclic antidepressants (TCA). TCAs used to treat migraine include:2

  • Amitriptyline
  • Nortriptyline

Another type of antidepressant that may be used to treat migraines is called a serotonin and norepinephrine reuptake inhibitor (SNRI). Examples of SNRIs used to treat migraine include:2

  • Venlafaxine
  • Duloxetine
  • Milnacipran

Lastly, a type of drug called a selective serotonin reuptake inhibitor (SSRI) may treat migraines. Fluoxetine is an SSRI that may help treat migraine in some people.2

What are the possible side effects of antidepressants?

Side effects can vary depending on the specific drug you are taking.

TCA side effects

Side effects of TCAs may include:2

  • Tiredness
  • Weight gain
  • Dry mouth
  • Constipation

SNRI side effects

Side effects of SNRIs may include:2

  • Nausea
  • Hot sweats
  • Constipation
  • Dry mouth
  • Trouble sleeping
  • Tiredness
  • High blood pressure

SSRI side effects

Side effects of SSRIs may include:2

  • Nausea
  • Diarrhea
  • Tiredness
  • Trouble sleeping

All antidepressants may cause an increased risk of suicidal thoughts. Contact your doctor if you notice changes in your thoughts or mood while taking antidepressants.3

It is important not to stop taking any antidepressants suddenly. This can cause negative side effects and increases the risk for depressive thoughts. If you need to stop taking an antidepressant, your doctor will work with you to slowly cut your dose back.1

These are not all the possible side effects of antidepressants. Talk to your doctor about what to expect when taking antidepressants. You also should call your doctor if you have any changes that concern you when taking antidepressants.

Things to know about antidepressants for migraine

Amitriptyline is the best-studied and most common antidepressant used for migraine prevention. It has a long history of use for migraine. For some people, amitriptyline may work well but cause intolerable side effects. In this case, nortriptyline may be an alternative. It is a TCA-like amitriptyline but causes fewer side effects.2

SSRIs or SNRIs may be another option for treating migraine. Of these drugs, venlafaxine is most commonly used for migraine. If the side effects of venlafaxine are not bearable, a doctor may recommend duloxetine. Duloxetine is also an SNRI, but it causes less intense side effects.2

Before beginning treatment for migraine, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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Written by: Juliette Daly | Last reviewed: September 2021