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Migraine....depression....medi­cation?

Q.I have had very good luck with the SSRIs as antidepressants. I've been on Prozac, Zoloft, and now Celexa. I think they also have an effect in me of reducing the number and severity of my migraines. Is there some reason your MD hasn't tried you on the SSRIs? They are very commonly prescribed.

A.I am not a doctor, nor do I play one on TV. However, I have some life experience in this area. I would suggest that you keep going back to your Psychiatrist. There are many other anti-depressants that he can try. I have had some success with Paxil & Depakote in the areas of depression & migraine preventives. I've seen several studies that suggest co-morbidity, preventative therapies that include tricyclic antidepressants, MAOI's or sodium valproate. Medication that is not recommended in depression with migraine - beta blockers and flunarizine. As I said a combination of soduim valrote and the Paxil SSRI seems to be working for me. Unfortunately a lot of meds are trail & error. Don't give up just because one didn't work. it may take some experimentation to find something that will help the depression and not exacerbate the migraines. The older, tricyclic antidepressants are actually among the front-line preventives for migraine, and may be your treatment of choice. Nothing is perfect...they have some side effects, too. But you should hop, skip and jump into the office of a good neurologist and/or psychiatrist who can go through the treatment options with you, with a PDR in hand. And don't forget, in this medication-obsessed age, that some studies have shown that psychotherapy + sunshine + exercise are as effective as drugs for relief of depression. Some depression, anyway.

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