Expert Opinion: Migraine, Psychiatric Comorbidities, and Treatment
April 2008
in “
Headache
”
TLDR People with migraines often have mental health conditions, and treatment should be personalized to address both issues safely.
The document explored the intricate link between migraines and psychiatric comorbidities such as depression, anxiety, and bipolar disorder, noting that over 50% of migraine sufferers were undiagnosed and often had higher rates of psychiatric disorders. The odds ratio between migraine and major depression ranged from 2.2 to 4.0, with anxiety disorders frequently preceding migraines and depression. Treatment required individualized approaches, with tricyclic antidepressants like amitriptyline being effective but having significant side effects, while SSRIs and SNRIs showed varying efficacy and side effect profiles. Non-pharmacological treatments like cognitive behavioral therapy were also beneficial. The genetic basis for these comorbidities remained speculative, necessitating further research.
