Antidepressants for tension headaches

Antidepressant medications, which are usually used to treat depression, can be effective in preventing chronic tension headaches. Antidepressants have some pain-relieving properties and may reduce how often headaches occur and how long they last. Antidepressants are also used to improve sleep problems.

Antidepressants that are used to reduce the frequency or duration of tension headaches usually include:

• Tricyclic antidepressants.
• Selective serotonin reuptake inhibitors (SSRIs).

Tricyclic antidepressants usually work better than SSRIs to prevent chronic headaches.¹ Amitriptyline, a tricyclic antidepressant, has been proven to reduce how often tension headaches occur and how long they last.² If you do not respond well to amitriptyline, you may try other tricyclic antidepressants, although they may not work as well to relieve your headache.

Side effects of tricyclic antidepressants include:

• Dry mouth.
• Constipation.
• Blurred vision.
• Inability to urinate.
• Weight gain.
• Low blood pressure when you stand up quickly.

Common side effects of SSRIs include:

• Nausea.
• Changes in appetite.
• Diarrhea.
• Anxiety or drowsiness.
• Sleep problems.
• Loss of sexual desire or ability.
• Headaches.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.

Citations

1. Moja PL, et al. (2005). Selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headaches. Cochrane Database of Systematic Reviews (1).

2. Silver N (2006). Headache (chronic tension-type), search date October 2005. Online version of Clinical Evidence (15).