Do Antidepressants Have Benefits For People Who Suffer From Migraines?

Contrary to popular belief, antidepressants can be an effective form of treatment for not just depression but also a variety of other conditions. According to a 2023 article published in StatPearls, those with obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), anxiety, social phobias, and more, may also benefit from taking antidepressants for symptom relief. Additionally, these medications are sometimes prescribed to patients experiencing sleeping difficulty, chronic pain, hot flashes, or eating disorders (via Healthline). 

The one-sided painful throbbing that characterizes a migraine — which can be set off by a number of different things, including weather changes, lack of sleep, stress, bright lighting, or forgetting to eat — is known well by those who suffer from them. Learning that the effects of antidepressants may be more far-reaching than you previously thought, including pain relief, you may be wondering if they could be helpful in treating migraines. Here's what the science says.

Antidepressants are not considered a cure for migraine headaches, but some research suggests they may be beneficial when it comes to preventing or reducing the severity of a migraine attack (via Health Union).

In a 2017 literature review published in Medicine, researchers pulled studies from across four different scientific databases. They analyzed 12 clinical trials involving more than 1,000 adult patients diagnosed with migraine headaches. The majority of the trials compared the efficacy of tricyclic antidepressants (TCAs) against a placebo, while the remaining trials looked specifically at the use of amitriptyline (a type of TCA) in conjunction with either selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

The study findings revealed that TCAs were significantly more effective at reducing the severity of a migraine when compared to the placebo group — by as much as 50% or more. Similar outcomes were observed with the use of SSRIs and SNRIs. Little difference in migraine prevention was observed between amitriptyline and either SSRIs or SNRIs. Overall, however, the placebo, SSRIs, and SNRIs were better tolerated by patients in regard to side effects. Reported side effects associated with TCA usage included dry mouth, drowsiness, nausea, dizziness, weight gain, and digestive discomfort.

While some research has found that taking certain antidepressants may be beneficial for patients with migraine headaches, other research presents somewhat conflicting evidence. For example, although SSRIs were found to be helpful in alleviating patient migraine symptoms in the aforementioned study, an alternate 2019 scientific review published in Current Treatment Options in Neurology found that SSRIs were predominantly unhelpful for patients suffering from migraines.

So, how can the potential connection between antidepressants and migraine relief be explained? Experts say that it likely has to do with certain neurotransmitters in the brain. Serotonin and norepinephrine, in particular, are both involved in regulating physical pain and mood (via Health Union). In turn, antidepressants operate by restoring balance to levels of these chemicals in the brain.

If you suffer from migraines, talk to your doctor about whether or not antidepressants may be a suitable treatment option for you. Alternate medications may be prescribed that can help prevent or treat symptoms in the midst of a headache. According to the National Institute of Neurological Disorders and Stroke, relaxing in a dark quiet room, using a cold compress on your forehead, staying adequately hydrated, or even minor caffeine consumption may also help in treating migraine.