Fluoxetine prophylaxis of migraine
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C Adly1, J Straumanis, A Chesson
1Department of Psychiatry, Louisiana State University School of Medicine, Shreveport.
Abstract:
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 pathogenesis, we investigated in a double blind, placebo controlled study the prophylactic effect of the serotonergic drug fluoxetine. Sixteen subjects were randomly assigned to 8 week fluoxetine 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.
Insights
Fluoxetine effectively reduced severe migraine headaches in a clinical trial. This serotonin-based medication offers a safe prophylactic option for patients unresponsive to other treatments.
Area of Science:
- Neurology
- Pharmacology
Background:
- Severe migraine patients often lack effective treatments or experience intolerable side effects.
- Serotonin dysregulation is implicated in the underlying mechanisms of migraine.
Purpose of the Study:
- To investigate the prophylactic efficacy of fluoxetine, a serotonergic drug, in patients with severe migraine.
Main Methods:
- A double-blind, placebo-controlled study was conducted over 8 weeks.
- Participants were randomly assigned to receive either fluoxetine or a placebo.
- Migraine headache and depression scores were recorded throughout the study.
Main Results:
- Fluoxetine significantly reduced migraine headache scores from weeks 3-4 onwards.
- No significant changes in headache scores were observed in the placebo group.
- No significant differences in depression scores were found between the fluoxetine and placebo groups.
Conclusions:
- Fluoxetine demonstrates potential as a safe and effective prophylactic treatment for severe migraine.
- Further large-scale, long-term studies are warranted to confirm these findings.