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 .
S-Fluoxetine in the Prophylaxis of Migraine: A Phase II Double-Blind Randomized Placebo-Controlled Study
S-fluoxetine is the long-acting enantiomer of the racemic antidepressant serotonin reuptake inhibitor .  Sixty-five patients needing migraine prophylaxis were recruited into a phase II , double-blind , placebo-controlled trial . After a 1-month placebo run-in , 53 patients met entry criteria with regard to attack frequency and were r and omized , 27 to S-fluoxetine and 26 to matching placebo .  Three failed to start treatment and mere were 17 early discontinuations , 9 from S-fluoxetine , 8 from placebo , at similar times and for similar reasons . The primary efficacy variable was attack frequency and analysis compared decline-from-baseline in the two groups . This was earlier and greater ( 1.7 attacks/28 days , or 52 % ) on active therapy than on placebo ( 1.1 attacks/28 days , or 27 % ) , and statistically significant in month 2 ( F=4.93 ; p=0.033 ) and month 4 ( F=4.55 ; p=0.041 ) . As secondary measures of efficacy , migraine-days per month and Patient 's Global Impression of Disease Severity coherently reflected the changes in attack frequency . Mean attack severity and acute medication use ( doses per attack ) were unaltered by either treatment . There were no serious adverse events . Withdrawals for adverse events were four from each group but none was considered causally related . The finding of greater efficacy of S-fluoxetine than of placebo should be interpreted conservatively , since the analysis in the final month was made on only half of the entered patients . It supports progression to phase III evaluation , which was the purpose of the study
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 .