Current Recommendation

US Headache Consortium

“Recommended agents based on consensus and clinical experience: cyproheptadine, bupropion, diltiazem, doxepin, fluvoxamineb, ibuprofen, imipramine, mirtazepine, nortriptyline, paroxetineb, protriptyline, sertralineb, tiagabine, topiramate, trazodone, venlafaxineb” [ 5 ]

American Academy of Family Physicians and the American College of Physicians-American Society of Internal Medicine (ACP-ASIM)

No recommendation made about the use of SSRIs and/or SNRIs for the preventative treatment of migraine [ 5 ]

American Academy of Neurology (AAN) and the American Headache Society (AHS)

Anti-depressants, SSRIs, SNRIs, tricyclic antidepressants [TCAs]and venlafaxineb are classified as Level B: medications are “probably effective” (one class 1 or two class 2 studies) [ 6 ]

Fluvoxamineb and fluoxetineb, i.e. two specific SSRIs, are classified as Level U: “inadequate or conflicting data to support or refute use” [ 6 ]