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How Effective Is Amitriptyline for Migraines?

By S. Berger
Updated Mar 03, 2024
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Amitriptyline is a medication classified as a tricyclic, and it is used to treat migraine headaches, as well as other medical conditions such as depression and other mood disorders. Some doctors recommend amitriptyline for migraines to prevent these incapacitating headaches. This medication is not generally used to treat symptoms of headaches after they have developed, but are considered a preventative measure.

Like other tricyclics, this drug affects levels of neurotransmitters, chemicals used by brain cells to communicate with one another. Specifically, it prevents the breakdown of chemicals like norepinephrine and serotonin. Taking amitriptyline for migraines can be effective because the increased serotonin levels from this medication constrict blood vessels that normally become enlarged during a migraine attack. Keeping these vessels constricted helps to prevent the headaches from developing.

There is solid scientific research to support taking amitriptyline for the relief of migraines. One study involving 100 people with migraines found that taking this drug for four weeks created improvements for 55 percent of individuals. Those showing improvement reported at least a 50 percent reduction in migraines.

Amitriptyline's action as an antidepressant may factor into how effective it is at treating headaches for some people. In the study mentioned above, depressed individuals with less problematic headaches, as well as people with severe headaches, but no depression, using amitriptyline for migraines tended to experience the most relief from symptoms. Depressed individuals with more severe headaches did not experience nearly as much relief from the frequency and severity of their headaches.

Side effects can sometimes determine whether a medication is given to certain individuals. Taking amitriptyline for migraines can lead to a variety of side effects, with more common effects including dry mouth, dizziness, nausea and upset stomach. Such side effects do not normally require the attention of a doctor, and tend to stop after days or weeks of treatment. Medical attention should be sought if side effects like numbness of the extremities, chest pain, confusion, or suicidal thoughts occur.

Amitriptyline can also cause interactions with other drugs, which can limit its use and efficacy. Other antidepressants, including other tricyclics, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs) can influence how amitriptyline affects a person, even if they were taken weeks before. Alcohol may cause interactions that affect mood and increase certain side effects, especially if a large amount is consumed. Heart rhythm medications and other drugs used to treat psychiatric disorders have the potential for harmful interactions, as well.

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Discussion Comments
By ysmina — On Nov 04, 2013

@fBoyle-- I don't think that amitriptyline works for everyone. Amitriptyline causes headaches and migraines in some people as a side effect. So I think it can make migraines worse. The best way to know whether amitriptyline will work for migraines is to try it I guess.

Amitriptyline did not cure my migraines but it did reduce them. It took a while to see this effect though. I didn't have any improvement for the first several weeks. I was taking 20mg/day.

I stopped taking it not because of its effects on my migraines, but because of the side effects. It was making me gain weight and I felt lethargic. But it was actually one of the few drugs that had an effect on my migraines. I've taken other drugs that did absolutely nothing.

By fBoyle — On Nov 03, 2013

@donasmrs-- May I ask what dose you are on?

I was on a low dose of amitriptyline for migraines (10mg/day) and it actually made my migraines worse. My doctor didn't understand why either. I gave it a few weeks and eventually quit. I might be an exception though because many people report that amitriptyline has reduced their migraines.

By donasmrs — On Nov 03, 2013

I wasn't put on amitriptyline for migraines. In fact, I didn't even know that it's beneficial for migraines. I was put on it for depression and found out by chance that it also prevents migraines for me.

A few weeks after starting the medication, I noticed that I was having migraines less frequently and when I did have them, they were less intense. I've been on amitriptyline for several months now and my migraines are practically gone. It has been a very pleasant surprise.

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