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 .
Fluoxetine for migraine prophylaxis: a double-blind trial.
UNLABELLED Selective serotonin reuptake inhibitors have recently been used in the treatment of migraine . OBJECTIVE We studied the safety and efficacy of fluoxetine in the prevention of migraine . PATIENTS Between February 1997 and December 1997 , we examined 52 patients ( 33 women ) at the Headache Diagnosis and Therapy Service of the Second University of Naples . Ages ranged from 18 to 65 years , and all patients suffered from migraine without aura according to IHS 1988 criteria . The sample was divided into two groups : group A included 32 patients ( 19 women ; mean age , 36.8 years [ SD 12.4 ] ) who received fluoxetine at a dosage of 20 mg per day ; group B included 20 patients ( 14 women ; mean age , 38.8 years [ SD 15.6 ] ) who received placebo . METHODS Our study was a single-center , r and omized , double-blind , parallel study of fluoxetine for the prophylactic control of migraine and consisted of two phases : 30 days of pharmacological wash out and 6 months of therapy with monthly follow-up . Patients were r and omly assigned to two groups : A , fluoxetine or B , placebo . At the first visit , patients provided a detailed history and underwent neurological evaluation and a Zung test for depression . No pathological values were revealed . In order to monitor symptomatology , all patients received a form for the calculation of the total pain index at monthly follow-up . RESULTS A comparison of the total pain index between basal values ( calculated during the period of wash out ) and monthly follow-up ( calculated monthly during the period of 6 months of the therapy ) showed significant reduction ( P < .05 ) beginning from the third month of treatment in the fluoxetine group and no significant reduction in the placebo group . CONCLUSION Even if preliminary and to be confirmed , these data seem to support the use of fluoxetine in the treatment of migraine
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 .