Migraine treatment: Can antidepressants help?

My doctor prescribed sertraline (Zoloft) for my migraines. Is this an appropriate migraine treatment? I don't have depression.

- Lori / New Mexico

Answer

There's no good evidence that sertraline (Zoloft), a selective serotonin reuptake inhibitor (SSRI), can prevent migraines.

Certain antidepressants can help prevent migraines. Most effective are tricyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and protriptyline (Vivactil). In fact, these medications are considered among first-line treatment agents and may reduce migraines by affecting the level of serotonin and other chemicals in your brain. Also, you don't have to have depression to benefit from these drugs.

However, newer antidepressants — such as Zoloft and other SSRIs — generally aren't effective for migraine prevention.

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