Medications to help with depression?

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    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;


    I'm not sure if you're talking about "depression" during Migraine attacks or the "full-time" depression that Migraineurs so often experience.


    In the general population, 17% experience major depressive disorder. That percentage jumps to 47% among Migraineurs. In those cases, Migraine disease and major depressive disorder are comorbid, meaning that they occur simultaneously, but neither causes each other. Tricyclic antidepressants such as amitriptyline are sometimes prescribed both for depression and Migraine prevention. However, the tricyclics are primitive medications; we have much better ones now. One that we're seeing success with, again for both depression and Migraine prevention, is Effexor XR. It's an SNRI, affecting both serotonin and norepinephrine.

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    On the other hand, depression during a Migraine attack is a symptom of the Migraine, caused by fluctuations in nerutransmitters such as serotonin, norepinephrine, and dopamine. Antidepressants are not prescribed for this short-lived, symptomatic depression. It is best served by aborting Migraines as early and quickly as possible.


    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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    Last updated September 30, 2008.


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Published On: September 30, 2008