Fluoxetine Prophylaxis of Migraine

Adly, Camran; Straumanis, John J.; Chesson, Andrew L.

doi:10.1111/j.1526-4610.1992.hed3202101.x

Cited by 96 publications

(62 citation statements)

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“…Fluoxetine. In the original guideline, 1 Class II study 27 showed fluoxetine (racemic) was significantly better than placebo for migraine prevention, but the results were not duplicated in a second study. 28 Since the original guideline, a Class II study has shown fluoxetine 20 mg/day was more effective than placebo in reducing total pain index scores (calculated as […”

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confidence: 99%

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

et al. 2012

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Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention? Methods:The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications available in the United States for migraine prevention. Results and Recommendations:The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein. Divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A). Frovatriptan is effective for prevention of menstrual migraine (Level A). Lamotrigine is ineffective for migraine prevention (Level A). Neurology Epidemiologic studies suggest approximately 38% of migraineurs need preventive therapy, but only 3%-13% currently use it.1 In 2000, the American Academy of Neurology (AAN) published guidelines for migraine prevention.2,3 Since then, new clinical studies have been published on the efficacy and safety of migraine preventive therapies. This guideline seeks to assess this new evidence to answer the following clinical question: For patients with migraine, which pharmacologic therapies are proven effective for prevention, as measured by reduced migraine attack frequency, reduced number of migraine days, or reduced attack severity? This article addresses the safety and efficacy of pharmacologic therapies for migraine prevention.Separate guidelines are available for botulinum toxin. 4 The 2008 guideline included a Level B recommendation that botulinum toxin was probably ineffective for treatment of episodic migraine. A new guideline is in development. An updated guideline on nonsteroidal anti-inflammatory drugs 5 and complementary alternative treatments has been approved for publication as a companion to this guideline. 5 DESCRIPTION OF THE ANALYTIC PROCESSThe AAN and the American Headache Society participated in the development process. An author panel of headache and methodologic experts was assembled to review the evidence. Computerized searches of the MEDLINE, PsycINFO, and CINAHL databases identified new studies (published in English). The search strategy used the MeSH term "headache" (exploded) and a published search strategy for identifying randomized controlled trials ( Appendices e-1-e-5, reference e1, and tables e-1 and e-2 are available on the Neurology Web site at www.neurology.org.

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confidence: 99%

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

et al. 2012

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“…14 The fluoxetine group had a significant reduction in headache scores after 10 weeks compared with the placebo group ( p Ͻ .05).…”

Section: Headachementioning

confidence: 99%

The Efficacy of Selective Serotonin Reuptake Inhibitors for the Management of Chronic Pain

1997

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OBJECTIVE:To assess the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in the management of chronic pain. METHODS:Randomized, controlled trials of SSRIs in the management of chronic pain were identified by searching MEDLINE from 1966 to 1997 and by contacting the manufacturers of SSRIs available in the United States. MAIN RESULTS:Nineteen studies were identified, including 10 on the treatment of headache, 3 on diabetic neuropathy, 3 on fibromyalgia, and 3 on mixed-chronic pain. SSRIs were consistently helpful for mixed-chronic pain. Results were conflicting for migraine headache, tension headache, diabetic neuropathy, and fibromyalgia. T he clinical management of chronic pain remains a challenge. Despite advances in pain research and clinical treatment, rates of disability due to chronic pain continue to climb worldwide. 1 Although chronic pain is treated with many medications, such as tricyclic antidepressants, nonsteroidal anti-inflammatory drugs, anticonvulsants, and opioids, none has shown outstanding efficacy. Narcotics are usually avoided because of the risk of developing tolerance, dependence, and functional deterioration. 2 Tricyclic antidepressants have proven efficacy in the treatment of chronic pain conditions such as diabetic neuropathy, fibromyalgia, chronic headaches, and post-herpetic neuralgia. 3 Their ability to relieve pain in these conditions appears to be independent of their antidepressant effect and may be related to their effect on neuronal reuptake of serotonin and norepinephrine. Unfortunately, side effects including dry mouth, constipation, orthostatic hypotension, and urinary retention often limit their use. CONCLUSIONS:Fluoxetine was introduced as the first selective serotonin reuptake inhibitor (SSRI) in the United States in 1988. Since then, SSRIs have become the most frequently prescribed antidepressant medications owing to their favorable side-effect profile. 4 More than half of antidepressant prescriptions written in the primary care setting are for conditions other than depression. 5 There is considerable interest in the use of SSRIs for the management of chronic pain, although they are not currently approved by the Food and Drug Administration for this purpose. This review summarizes available data on the value of these medications for pain control in several clinical situations. METHODSWe used the National Library of Medicine search engine to search MEDLINE from 1966 to 1997 using the medical subject heading (MeSH) term "pain," exploding it, and adding the following words in all fields: pain, neuropathy, migraine, and fibromyalgia. We also searched using the MeSH term "serotonin uptake inhibitors" and the following words in all fields: sertraline, paroxetine, fluoxetine, fluvoxamine, femoxetine, zimelidine, and citalopram. We combined results of these two searches with the term "and," and selected for review randomized double-blind, controlled studies published in English and performed on humans. References from studies reviewed provided additional sources of...

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“…Early studies of the SSRI fluoxetine previously had demonstrated mixed results [Adly et al, 1992;Saper et al, 1994]. An additional, placebo-controlled trial reinforced the potential benefit of this agent in the longterm treatment of migraine [d 'Amato et al, 1999].…”

Section: Antidepressantsmentioning

confidence: 98%

Newer aspects of migraine preventive therapies

Freitag

2007

Drug Development Research

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Migraine preventive therapy includes treatment with pharmacological therapies that result in the reduction of the frequency, severity, or intensity of attacks. There are sufficient data to make recommendations for the following seven pharmacological agents for migraine prevention: topiramate, divalproex sodium, amitriptyline, metoprolol, propranolol, timolol, and Petasites. Additional evidence and treatment recommendations are reviewed on the specific efficacy and safety of several other therapies tested for migraine prevention. Drug Dev Res 68:315-320, 2007.

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Fluoxetine Prophylaxis of Migraine

Cited by 96 publications

References 1 publication

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

The Efficacy of Selective Serotonin Reuptake Inhibitors for the Management of Chronic Pain

Newer aspects of migraine preventive therapies

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