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 .
Propranolol and femoxetine, a HT-uptake inhibitor, in migraine prophylaxis. A double-blind crossover study.
The prophylactic effect of the 5-HT uptake inhibitor femoxetine was compared with propranolol ( Frekven R ) in a double-blind crossover trial of 6 months duration . Forty-nine patients commenced the trial . Twelve patients withdrew because of drug failure or failure to attend checkups ( 6 ) , side effects ( 4 ) or other non-drug related causes ( 2 ) . In the 37 patients who completed the trial there was no significant difference between propranolol 160 mg and femoxetine 400 mg with respect to the number of headache days or the number of migraine attacks during the last 2 months of each treatment , Propranolol , however , was superior to femoxetine when the headache index was used ( P less than 0.05 ) . The study has shown that partial depletion of thrombocyte 5-HT by a 5-HT uptake inhibitor does not lead to a marked improvement in all patients contrary to what might be expected from the 5-HT hypothesis of migraine . Nevertheless , due to the infrequent subjective side effects associated with femoxetine treatment it may be a valuable prophylactic drug to a subgroup of migraine 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 .