Two studies compared SSRIs or SNRIs versus amitriptyline and found no evidence for a difference in terms of migraine frequency ( st and ardised mean difference ( SMD ) 0.04 , 95 % confidence interval ( CI ) -0.72 to 0.80 ; I(2 ) = 72 % ) , or other secondary outcomes such as migraine intensity and duration .SSRIs  or SNRIs were generally more tolerable than tricyclics .
Since the last version of this review , the new included studies have not added high quality evidence to support the use of SSRIs or venlafaxine as preventive drugs for migraine .
There is no evidence to consider SSRIs or venlafaxine as more effective than placebo or amitriptyline in reducing migraine frequency , intensity , and duration over two to three months of treatment .
Our conclusion is that the use of SSRIs and SNRIs for migraine prophylaxis is not supported by evidence
BACKGROUND This is an up date d version of the original Cochrane review published in 2005 on selective serotonin reuptake inhibitors ( SSRIs ) for preventing  migraine and tension-type headache .
Another up date d review is under development to cover tension-type headache .
Migraine is a common disorder .
The chronic forms are associated with disability and have a high economic impact .
In view of discoveries about the role of serotonin and other neurotransmitters in pain mechanisms , selective serotonin reuptake inhibitors ( SSRIs ) and serotonin-norepinephrine reuptake inhibitors ( SNRIs ) have been evaluated for the prevention of migraine .
OBJECTIVES To determine the efficacy and tolerability of SSRIs and SNRIs compared to placebo and other active interventions in the prevention of episodic and chronic migraine in adults .
Migraine and reduced work performance
objectiue This article estimates lost work days and lost work day equivalents in a population sample of migraineurs , differentiating work loss due to headache episodes that met criteria for migraine from migrainous headaches not meeting full criteria and nonmigrainous headaches . Methods A r and  om digit dialing survey of 5,071 adults identified 800 subjects with migraine headaches . By clinical examination , a sub sample of 225 met migraine diagnostic criteria ; 174 of these patients completed at least 11 weeks of daily diaries . This report concerns the subgroup of 122 individuals with regular paid employment . Subjects completed a daily diary over a 3-month period to assess the occurrence of headaches and International Headache Society ( IHS ) criteria for each headache occurrence . We report estimates of lost work days and lost work day equivalents by type of headache . Results Participants reported headaches on 8.1 work days , of which 2.2 headache days met criteria for migraine ( IHS 1.1 , 1.2 ) , and an additional 2.1 headache days were migrainous without meeting full migraine criteria ( IHS 1.7 ) . On average , migraineurs missed 1.1 days of work due to headache in 3 months , of which 0.7 lost work days were due to migraine and 0.3 were due to migrainous headaches . When at work with headache , work effectiveness was reduced 41 % for migraine headaches , 28 % for migrainous headaches , and 24 % for other headaches . Over 3 months , migraineurs experienced an average of 3.0 lost work day equivalents , of which 1.4 were due to migraine and an additional 0.7 were due to migrainous headaches . The most disabled 20 % of the participants accounted for 77 % of the lost work days ; 40 % of subjects accounted for 75 % of the lost work day equivalents . Conclusions Employed migraine sufferers experienced considerable work loss and reduced work performance due to headache . The most severely affected migraineurs accounted for most of the reduced work performance . Targeting the most severely affected persons may be necessary to reduce work loss among migraineurs substantially . NEUROLOGY
Two studies compared SSRIs or SNRIs versus amitriptyline and found no evidence for a difference in terms of migraine frequency ( st and ardised mean difference ( SMD ) 0.04 , 95 % confidence interval ( CI ) -0.72 to 0.80 ; I(2 ) = 72 % ) , or other secondary outcomes such as migraine intensity and duration .SSRIs  or SNRIs were generally more tolerable than tricyclics .
Since the last version of this review , the new included studies have not added high quality evidence to support the use of SSRIs or venlafaxine as preventive drugs for migraine .
There is no evidence to consider SSRIs or venlafaxine as more effective than placebo or amitriptyline in reducing migraine frequency , intensity , and duration over two to three months of treatment .
Our conclusion is that the use of SSRIs and SNRIs for migraine prophylaxis is not supported by evidence
BACKGROUND This is an up date d version of the original Cochrane review published in 2005 on selective serotonin reuptake inhibitors ( SSRIs ) for preventing  migraine and tension-type headache .
Another up date d review is under development to cover tension-type headache .
Migraine is a common disorder .
The chronic forms are associated with disability and have a high economic impact .
In view of discoveries about the role of serotonin and other neurotransmitters in pain mechanisms , selective serotonin reuptake inhibitors ( SSRIs ) and serotonin-norepinephrine reuptake inhibitors ( SNRIs ) have been evaluated for the prevention of migraine .
OBJECTIVES To determine the efficacy and tolerability of SSRIs and SNRIs compared to placebo and other active interventions in the prevention of episodic and chronic migraine in adults .