Over 2 months of treatment , SSRIs are no more efficacious than placebo in patients with migraine .
In patients with chronic TTH , SSRIs are less efficacious than tricyclic antidepressants .
In comparison with SSRIs , the burden of adverse events in patients receiving tricyclics was greater .
BACKGROUND Headache is a common medical problem .
In view of recent discoveries about the role of serotonin in pain mechanisms , selective serotonin re-uptake inhibitors ( SSRIs ) have been evaluated for the prevention of  migraine and tension-type headaches ( TTH ) .
OBJECTIVES To evaluate the efficacy and tolerability of SSRIs for preventing migraine and TTH .
Chronic tension-type headache, mood depression and serotonin: therapeutic effects of fluvoxamine and mianserine.
Forty out- patients affected by chronic tension-type headache were selected according to the diagnostic criteria of International Headache Society ( IHS ) Headache Classification Committee . In a controlled trial patients received placebo for a four-week baseline period , then they were r and omized in double-blind fashion to therapy with mianserine ( 30 - 60 mg/day ) of fluvoxamine ( 50 - 100 mg/day ) for another eight-week period . Frequency of headache , pain severity and analgesic consumption were evaluated using a self-monitoring system . Mood depression was evaluated at 0 , 4 and 8 weeks by using Zung 's Self-Rating Depression Scale and Hamilton Rating Scale for Depression . Both drugs were beneficial in the treatment of chronic tension-type headache .  Non-depressed subjects with more severe headache responded best to fluvoxamine , whereas mianserine was more effective in the treatment of depressed patients with moderate headache . These results suggest that central serotoninergic neurotransmission can play a role in the pathophysiology of chronic tension-type headache also in non-depressed patients
Over 2 months of treatment , SSRIs are no more efficacious than placebo in patients with migraine .
In patients with chronic TTH , SSRIs are less efficacious than tricyclic antidepressants .
In comparison with SSRIs , the burden of adverse events in patients receiving tricyclics was greater .
BACKGROUND Headache is a common medical problem .
In view of recent discoveries about the role of serotonin in pain mechanisms , selective serotonin re-uptake inhibitors ( SSRIs ) have been evaluated for the prevention of  migraine and tension-type headaches ( TTH ) .
OBJECTIVES To evaluate the efficacy and tolerability of SSRIs for preventing migraine and TTH .