Debilitating depression with migraines?

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  • Full Question:

    The depression that seems to go along with the migraines is sometimes just as debilitating as the migraines themselves. Are there medications I should ask my neurologist about that can help this? Are there certain antidepressants to avoid? Karen.




    Dear Karen;


    Do you mean feeling depressed during a Migraine or all the time?


    Depression, anxiety, even panic attacks can happen during a Migraine as symptoms of the Migraine. There's not much to be done for those symptoms other than aborting the Migraine as quickly as possible. Of course, recognizing that what you're feeling is a symptom of the Migraine and will stop when the Migraine does is at least a bit comforting at the time.

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    If you mean all the time -- Migraine and depression are often comorbid conditions. That means that a person can have both at the same time, but neither one causes the other. Start by talking to your doctor. He may want to refer you to a psychologist or psychiatrist for diagnosis. If it's determined that you need medication, have the psychologist or psychiatrist consult with the doctor who treats you for Migraine regarding antidepressants. There aren't really antidepressants to avoid, but there are some that are more likely to help with Migraine prevention. Tricyclic antidepressants such as amitriptyline are rather primitive drugs, and there are better ones out there. In prescribing antidepressants for Migraine prevention, the current thinking is to use one that affects both serotonin and norepinephrine, SNRIs such as Effexor XR.


    Good luck,
    John Claude Krusz and Teri Robert



    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    © Teri Robert and J.C. Krusz, 2008.
    Last updated August 16, 2008.

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Published On: August 16, 2008