MRI Specialist Migraine Treatment Centers

Reference materials cited in a recent M-R-I paper discussing SSRI & SSNI in migriaine treatment:

Fluoxetine Prophylaxis of Migraine “Many patients with severe migraine remain refractory to the current treatment regimens or cannot tolerate the side effects. Since current research implicates serotonin dysregulation in migraine pethogenesis, we investigated in a double blind, placebo controlled study the prophylactic effect of the serotonergic drug fluoxatine. Sixteen subjects were randomly assigned to 8 week fluoxatine treatment and 16 to the placebo group; nine subjects in each group completed the study. Migraine headache scores were obtained for two weeks prior to commencement of treatment, and then for each successive two week period, Zung depression scores were obtained before and after completion of the study. Fluoxetine caused significant reduction in headache scores starting with weeks 3-4 of treatment; there was no significant change with placebo. Depression scores did not differ between groups before treatment, and did not significantly change with either treatment. Fluoxetine appears to be a safe and effective drug for migraine prophylaxis, and deserves further therapeutic trials with larger groups for longer periods of time…” 



A Comparative Study of Amitriptyline and Fluvoxamine in Migraine Prophylaxis“Current treatment of migraine either abortive or prophylactic is often unsatisfactory. Prophylactic treatment of severe migraine may reduce attack frequency, and current therapy centers on beta-blockers, serotonin (5-HT) reuptake blockers and 5-HT2 receptor antagonists. The author compared the efficacy and safety of amitriptyline and fluvoxamine among migraine patients (24F, 8M vs. 23F, 9M) in a double blind study. The efficacy of amitriptyline has already been established by earlier clinical studies. The other investigated drug, fluvoxamine, has a more selective 5-HT reuptake blocking property than amitriptyline. In this study, amitriptyline significantly reduced the number of headache attacks, but it caused severe drowsiness in many migraineurs. The fluvoxamine also favorably influenced on the number of headache attacks and caused only slight side effects…” 



Venlafaxine versus amitriptyline in the prophylactic treatment of migraine “In patients with migraine with or without aura the prophylactic effect of amitriptyline (AMT) and venlafaxine (VLF) was compared in a randomized double-blind crossover study. Intolerable side effects resulted in drop out of five patients on AMT (due to hypersomnia, difficulty in concentration and orthostatic hypotension) and one patient on VLF (because of nausea and vomiting). Following the run-in period the patients (n = 52) were randomly treated with one of the study medications for 12 weeks. After a wash-out period lasting 4 weeks the patients were treated with the other drug for further 12 weeks. Both drugs had significant beneficial effect on pain parameters…”



Selective serotonin reuptake inhibitors (SSRIs) and serotoninnorepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults – “This is an updated version of the Cochrane review published in 2005 on selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headache. The original review has been split in two parts and this review now only regards tension-type headache prevention. Another updated review covers migraine. Tension-type headache is thesecond most common disorder worldwide and has high social and economic relevance. As serotonin and other neurotransmitters may have a role in pain mechanisms, SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been evaluated for the prevention of tension-type headache…” 

Cochrane review on SSRIs and SNRIs and tension type headaches

Cochrane SSRI and SNRI in Migraines review 2015


Escitalopram and Venlafaxine for the Prophylaxis of Migraine Headache Without Mood Disorder – “There is evidence that some antidepressant drugs are beneficial in the prophylaxis of migraine. Previous reports have shown that migraine patientsmay respond tovariousantidepressant agents used for prophylactic therapy. The main purpose of this study was to compare the efficacy of antidepressants from 2 different groups (venlafaxine vs escitalopram) on people who had migraine headachewithout depression oranxiety.Inthisprospectivestudy,weevaluatedtheheadachediariesof 93 patients who were being treated with venlafaxine (n = 35) and escitalopram (n = 58). At the end of the 3-month period, patients were reassessed, and those with marked differences in attack frequency, duration, intensity (with visual analog scales), lost work-day equivalent index, and migraine disability assessment questionnaire were compared…”


Escitalopram_and_Venlafaxine_for_the_Prophylaxis.4 – tarlaci


Amitriptyline versus Amitriptyline combined with Fluoxetine in the preventative treatment of transformed migraine



Selective Serotonin Reuptake Inhibitors for Migraine Prophylaxis – “The objective of this study was to assess the efficacy of sertraline in migraine prophylaxis. Other selective sero- tonin reuptake inhibitors have been studied for migraine prophylaxis, but this is the first report with sertraline. Twenty-seven subjects were enrolled and baseline assessment of migraine frequency and severity were measured over a 4-week period. Subjects were then randomized to receive placebo or sertraline in a double-blind fashion with headache frequency and severity measured over an 8-week period. Subjects completed a daily diary report- ing the occurrence, severity, and degree of impairment associated with migraine…” 



Use of Amitriptyline and Fluoxetine in prophylaxis of migraine and tension-type headaches 



Efficacy and Safety of Venlafaxine in the Prophylaxis of Migraine –  “The efficacy of venlafaxine, which is selectively effective on the serotonergic and noradrenergic mechanisms, on various headaches and chronic pain syndromes has been demonstrated. To our knowledge, this is the first placebo-controlled, double-blind, randomized study of two different doses of venlafaxine for migraine treatment…”

Ozyalcin – The efficacy and safety of venlafaxine in the prophylaxis of migraine


S-fluoxetine in the prophylaxis of migraine: a phase II double-blind randomized placebo-controlled study



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