People are often surprised to hear that anti-depressant medications are offered in the treatment of migraine headaches. New migraine sufferers can feel a little shocked if their doctor recommends anti-depressants, especially when they have no depression symptoms or feelings.
How Migraine And Depression Are Linked
The term depression can be somewhat misleading because it’s generally assumed that having depression means feeling sad, low, or generally fed up all the time. However, real depression is caused by an imbalance in the chemicals within the brain and the ways in which these neurotransmitters function. People with frequent migraine headaches commonly also have brain chemical imbalances that affect their nerve signals and blood vessels.
While the links between migraine and depression are known, they’re not totally understood, and there is some debate on the cause and effect. Much like the chicken and the egg story, is it the migraine pain that causes depression, or does depression lead to migraine? Regardless of which causes which condition, knowing the two are linked helps doctors prescribe appropriate medication that can help prevent migraines. While not being a total cure, many sufferers find anti-depressants ward off the worst of the pain and, in some instances, regular medication can prevent the headache from developing.
How Anti-Depressants Help with Migraine Headache Pain
Anti-depressants prescribed for migraine treatment are intended to help prevent migraines from developing. Other types of drug, such as triptans, are commonly prescribed to treat the headache pain once it has started.
Tricyclic antidepressants work by affecting chemicals in the brain, especially serotonin levels. Serotonin is a neurotransmitter found in the brainstem and midbrain.
What Role does Serotonin Play in the Body?
Although serotonin in the brain is thought to be involved with coping mechanisms, and is the chemical link most often targeted by medications such as antidepressants, it’s interesting to note that only around 2% of the body’s serotonin is found in the brain. The rest is found in blood cells and the gut. As well as being responsible for other major jobs in the body, such as regulating bowel movements and helping with blood clotting at wound sites, serotonin plays an important role in mood, such as levels of anxiety or happiness. Too much serotonin can be as harmful as too little; for instance, too high a level is thought to increase the likelihood of osteoporosis in patients, especially when other risk factors are present.
The two types of most commonly prescribed antidepressant drugs are amitriptyline and nortriptyline, with both having proven effectiveness in preventing migraine. If these don’t work, there are others available. Tricyclic antidepressants are also known to be effective in treating anxiety and panic disorders, both of which are known dangers for migraine sufferers.
Side Effects From Antidepressants
Some people find the side effects of antidepressants difficult to cope with, although it’s important to realize that side effects are not a given. Some people experience them to worse degrees than others.
Which drug is most suitable for any individual may come down to a period of trial and error. Since there are various types available, it’s important that you consult your doctor if any side effects are too bothersome.
Typical side effects include:
- Blurring of your vision
- Difficulty urinating
- Low blood pressure
- Weight gain
- Dry mouth
Some people find that any side effects they experience subside after a time, while for others they continue and create additional physical problems. However, antidepressants shouldn’t be stopped suddenly as this can produce negative side effects. Instead, book a doctor’s appointment to discuss your side effects and a possible change to an alternative form or type of medication.
Antidepressant and Triptan Considerations
Triptans are commonly prescribed for the treatment of migraine pain once the headache has started, and it’s important that these are not taken alongside certain antidepressant drugs. In particular there are risks associated with mixing triptans and selective serotonin (SSRIs) and serotonin-norepinephrine (SNRIs) reuptake inhibitors as the mix can result in serotonin syndrome. It’s rare but serious, and can be fatal.
If you’re prescribed antidepressants for migraine treatment, don’t be alarmed as this doesn’t automatically mean your doctor thinks you’re depressed. However, because of the link between migraine headache and depression, and the similar causes and effects between the two conditions, appropriate antidepressant medication can be of significant help in reducing or preventing the onset of migraine pain.