How Effective Is Amitriptyline for Migraines?

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.
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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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