Antidepressants are medications that help to treat symptoms of depression. Most of them alter a type of chemical called a neurotransmitter. These carry messages between the cells in your brain.
Certain antidepressants can help reduce the frequency and severity of migraine attacks. You don’t have to be depressed to benefit from these drugs.
Tricyclic antidepressants, such as amitriptyline, are most commonly prescribed and likely work by affecting the level of serotonin and other chemicals in your brain. Serotonin levels also drop during a migraine. This might explain why antidepressants seem to help in prevention. There is little evidence that other classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), are particularly effective for migraine prevention, but some patients will find them of benefit.
Side effects of antidepressants vary from one medication to another and from person to person. Side effects may include weight gain, fatigue, constipation and dry mouth. Such side effects can make it difficult to stick with treatment.
If the medication doesn’t seem to be working or is causing bothersome side effects, talk to your doctor.
When taking an anti-depressant, it is important to discuss with your doctor whether you should be taking a Triptan as well to abort migraine attacks. As both medications alter serotonin, you may be at risk of serotonin syndrome.