SSRI for migraine prophylaxis

Clinical bottom line

There is no evidence that SSRIs are any better than placebo for preventing migraine headaches.

Reference

PL Moja et al. Selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headaches. Cochrane database of Systematic Reviews 2005 issue 3.

Methods of the review

Date review completed: 2003
Number of trials included: 13 trials with five SSRIs
Number of patients: 636
Control groups: placebo, or active comparisons
Main outcomes: headache index (a sum of time headache pain intensity and duration) and some adverse event measures.

Results

Only three trials with 86 patients reported efficacy against placebo over 8-12 weeks, two using fluoxetine and one sertraline. There was no difference in headache index between SSRI and placebo.

Small comparisons with active comparators were unhelpful.

Comment

There is no evidence that SSRIs are any better than placebo for preventing migraine headaches, though the amount of information is so small as to make no definite conclusion.