Overview
People with chronic migraine often experience depression or anxiety disorders. It’s not uncommon for people with chronic migraine to struggle with lost productivity. They may also experience poor quality of life. Some of this is due to mood disorders like depression, which may accompany migraines. In some instances, people with this condition also abuse substances.
Pain And Depression
Chronic migraine was once called transformative migraine. It’s defined as a headache that lasts 15 days or more a month, for more than three months. You might expect that someone living with chronic pain would also become depressed. Research shows that people with other chronic pain conditions, such as lower back pain, do not get depressed as often as people who have migraines. Because of this, there’s thought to be a link between migraine and mood disorders that is not necessarily due to the constant pain itself.
It’s unclear what the exact nature of this relationship might be. There are several possible explanations. Migraine may play a role in the development of mood disorders such as depression, or it could be the other way around. Alternatively, the two conditions might share an environmental risk factor. It is also possible, though unlikely, that the apparent link is due to chance.
People who experience more frequent migraine headaches report having lower quality of life than people with occasional headaches. Disability and lower quality of life are also worse when people with chronic migraine have depression or an anxiety disorder. Some even report worsening headache symptoms after an episode of depression.
Researchers have suggested that those who get migraines with aura are more likely to have depression than people who have migraine without aura. Due to the possible connection between chronic migraines and major depression, doctors are urged to screen those with migraines for depression.
Medication Options
When depression accompanies chronic migraine, it may be possible to treat both conditions with an antidepressant medication. However, it’s important not to mix selective serotonin reuptake inhibitor (SSRI) drugs with triptan drugs. These two classes of medication can interact to cause a rare and possibly dangerous side effect called serotonin syndrome. This potentially fatal interaction results when the brain has too much serotonin. SSRIs and a similar class of drugs called selective serotonin/norepinephrine reuptake inhibitors (SSNRIs) are antidepressants that work by boosting the serotonin that’s available within the brain.
Triptans are a class of modern drugs used to treat migraine. They work by binding to receptors for serotonin in the brain. This reduces blood vessel swelling, which relieves migraine headache. There are presently seven different triptan medications available by prescription. There is also a drug that combines prescription triptan with over-the-counter pain reliever naproxen. Brand names include:
- Amerge
- Axert
- Frova
- Imitrex
- Maxalt
- Relpax
- Treximet
- Zecuity
- Zomig
This type of medication comes in:
- oral pill
- nasal spray
- injectables
- skin patch
The nonprofit consumer advocacy organization Consumer Reports compared the price and effectiveness of various triptans in a report published in 2013. They concluded that for most people, generic sumatriptan is the best buy.
Treatment Through Prevention
Triptans are only useful for the treatment of migraine attacks as they occur. They do not prevent headaches. Some other drugs may be prescribed to help prevent the onset of migraine. These include beta blockers, certain antidepressants, antiepileptic medications, and CGRP antagonists. It may also be helpful to identify and avoid triggers that can provoke an attack. Triggers may include:
- certain foods
- caffeine or caffeine-containing foods
- alcohol
- skipping meals
- jet lag
- dehydration
- stress
Sources:
- Antonaci, F., Nappi, G., Galli, F., Manzoni, G. C., Calabresi, P., & Costa, A. (2011, April). Migraine and psychiatric comorbidity: a review of clinical findings. Journal of Headache Pain, 12(2), 115-25
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072482 - Bellini, B., Arruda, M., Cescut, A., Saulle, C., Persico, A., Carotenuto, M., … Guidetti, V. (2013, September). Headache and comorbidity in children and adolescents. Journal of Headache Pain, 14(79). Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849985/ - Bigal, M. E., & Lipton, R. B. (2006, October). Modifiable risk factors for migraine progression. Headache, 46(9), 1334-43
http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2006.00577.x/epdf - Buse, D. C., Silberstein, S. D., Manack, A. N., Papapetropoulos S., & Lipton R. B. (2013, August). Psychiatric comorbidities of episodic and chronic migraine. Journal of Neurology, 260(8), 1960-9
http://link.springer.com/article/10.1007%2Fs00415-012-6725-x - Evaluating prescription drugs used to treat migraine headaches: The triptans. (n.d.). Retrieved from
http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/triptanFINAL.pdf - Frediani, F., & Villani, V. (2007 May). Migraine and depression. Neurology Science, 28(2), S161-5. Retrieved from
http://sibelium.kydev.net/sibelium/WX/fulltext_WX_3/14.pdf - Gesztelyi, G., & Bereczki, D. (2005 Aug.). Disability is the major determinant of the severity of depressive symptoms in primary headaches but not in low back pain. Cephalalgia, 25(8), 598-604
http://cep.sagepub.com/content/25/8/598.long - Guglielmo, R., Martinotti, G., Di Giannantonio, M., & Janiri, L. (2013 March-April). A possible new option for migraine management: Agomelatine. Clinical Neuropharmacology, 36(2), 65-7. Retrieved from
http://journals.lww.com/clinicalneuropharm/pages/articleviewer.aspx?year=2013&issue=03000&article=00008&type=abstract - Moon, J. S., Smith, J. H., Lahr, B. D., & Cutrer, F. M. (2013 August). Psychosomatics, 54(4), 317-27
http://www.sciencedirect.com/science/article/pii/S003331821200196X - Smitherman, T. A., Burch, R., Sheikh, H., & Loder, E. (2013 March). The prevalence, impact, and treatment of migraine and severe headaches in the United States: A review of statistics from national surveillance studies. Headache, 53(3), 427-36
https://www.ncbi.nlm.nih.gov/pubmed/23470015 - Verri, A. P., Proietti Cecchini, A., Galli, C., Granella, F., Sandrini, G., & Nappi, G. (1998). Psychiatric comorbidity in chronic daily headache. Cephalalgia, 21, 45-9
- Yong N., Hu H., Fan X., Li X., Ran L., Qu Y., … Zhou, J. (2012 June). Prevalence and risk factors for depression and anxiety among outpatient migraineurs in mainland China. Journal of Headache Pain, 13(4), 303-10
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356469/
Important Notice: This article was also published at www.healthline.com by Dale Kiefer where all credits are due. Medically reviewed by Timothy J. Legg, PhD, PsyD
Disclaimer
The watching, interacting, and participation of any kind with anything on this page does not constitute or initiate a doctor-patient relationship with Veripeudic.com. None of the statements here have been evaluated by the Food and Drug Administration (FDA). The products of Vesripeudic.com are not intended to diagnose, treat, cure, or prevent any disease. The information being provided should only be considered for education and entertainment purposes only. If you feel that anything you see or hear may be of value to you on this page or on any other medium of any kind associated with, showing, or quoting anything relating to Veripeudic.com in any way at any time, you are encouraged to and agree to consult with a licensed healthcare professional in your area to discuss it. If you feel that you’re having a healthcare emergency, seek medical attention immediately. The views expressed here are simply either the views and opinions of Veripeudic.com or others appearing and are protected under the first amendment.
Veripeudic.com promotes evidence-based natural approaches to health, which means integrating her individual scientific and clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise, I refer to the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice.
Veripeudic.com does not make any representation or warranties with respect to the accuracy, applicability, fitness, or completeness of any multimedia content provided. Veripeudic.com does not warrant the performance, effectiveness, or applicability of any sites listed, linked, or referenced to, in, or by any multimedia content.
To be clear, the multimedia content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any website, video, image, or media of any kind. Veripeudic.com hereby disclaims any and all liability to any party for any direct, indirect, implied, punitive, special, incidental, or other consequential damages arising directly or indirectly from any use of the content, which is provided as is, and without warranties.
