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. These findings suggest, that fluvoxamine may be an alternative drug in migraine prophylaxis, however, further studies should be performed with more subjects.