Depression

Depression and Migraine

There may also be a relationship between depression and migraines. Researchers have reported a weak but significant relationship between migraine and depression. They noted a high correlation between depression and migraine in relation to weakness, sensory disturbance, difficulty with speech and loss of consciousness. They postulated about a possible subgroup of patients in whom depression and migraine are linked and who are characterized by the presence of those focal neurological signs previously mentioned.

It has been proposed that the antimigraine effect of amitriptyline is independent of its antidepressant effect, but it is undetermined if this effect is due to blocking of the re-uptake of serotonin and, to a lesser degree, norepinephrine at the nerve endings, or due to its anticholinergic, antihistaminic and antiserotonergic actions. Further investigation is warranted in this possible link.

In summary, depression is a widespread affliction that can be treated, but first it must be unmasked. The physician should be cognizant that although the headache may be secondary to depression, the pain is very, very real. The patient should be reassured that he/she can be helped but it is not going to happen immediately and it will require time and complete cooperation.

The tricyclic antidepressants, the selective serotonin re-uptake inhibitors, and the monoamine oxidase inhibitors are agents of choice in the treatment of headaches associated with depression. A physician must prescribe these drugs.

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