SSRIs and migraines - desperate and need some educated views

[m.ninehouser]

i appreciate all of your help and advice.. i'm left with a couple more questions however, that i hope you can help me out with...

first, i'm a little confused. since an ssnri helped me for 4 years (probably) in reducing my migraines, then is it even worth trying other types of migraine preventatives as they don't seem to work the same way as ssnris. for example what beta blockers do seem to have nothing to do with what is causing my migraines if effexor did indeed help my migraines lessen. does that make any sense? i think it does to me... maybe.

also, is effexor safe to take long term? i got off of it because i couldn't afford it anymore, now at this point, if it will help take my worry and migraines away again, i'd love to start up again on a lower does. however my girlfriend and i are quite nervous that it isn't exactly the safest measure to stay on an antidepressant just to prevent natural migraine cycles... thanks in advance!

-m.

[clinicalguru3]

In principal my first choice for migraine prevention would not be an SSRI SNRI at this point in time unless there were other reasons such as mood problems etc which would benefit from these drugs.

Long term use of effexor is considered safe enough to be approved by the FDA, although there is always a limit to how much research data is at their disposal, especially regarding very long-term treatment.

At this point in time, if medication is indicated there are 2 logical approaches, both legitimate.

1) Re-introduce effexor as you had good experience in the past with it.
2) If the only issue is migraines and no mood / anxiety issues exist then therapy could be directed towards preventing the migraines only (and if the regular drugs don't help, at that point go back to effexor).

Hope that helps

[m.ninehouser]

i do suffer from generalized anxiety. it's heightened just now due to my frequent migraines; i'm constant feeling 'off' or sick due to worry. which is why i went on effexor 5 years ago.

i'd be willing to try other treatments first before going back on something as serious as effexor of course.. my concern is, though, if an snri helped me for 4 years because of it's function, regulating serotonin in my brain, why would any other migraine med help me? is that not a logical way to look at it? would a beta blocker that effects blood flow and the heart and all of that even have a chance of helping my migraines which i have reason to believe were caused by my brain chemistry? that's what i'm confused about just now and i can't ask a physician about it since i don't have the money. but i'm on your side here; i'd much rather not get on an antidepressant again and try to beat my anxiety naturally and get on something else that treats migraines and doesn't mess with my brain...

[clinicalguru3]

my concern is, though, if an snri helped me for 4 years because of it's function, regulating serotonin in my brain, why would any other migraine med help me? is that not a logical way to look at it? would a beta blocker that effects blood flow and the heart and all of that even have a chance of helping my migraines which i have reason to believe were caused by my brain chemistry? that's what i'm confused about just now

Well you have a point however it is not so simple because:-

a) "Regulating serotonin" is a complicated thing which I could explain now but won't as it would take me a few days

b) We don't actually understand how all of the meds work on migraines...just that they do and that's often enough to lead us to prescribe them.

All in all there is a lot of "try it and see" in headache treatment until we get to the best treatment for any individual.

[m.ninehouser]

i see. so just because an snri helped my migraines subside, it doesn't mean a beta blocker won't? that is right confusing.

i'm also concerned that going back on effexor may not yield the same results as before since i've been on celexa recently and had such a bad response to it and a rapid taper... ugh.

[clinicalguru3]

Well good luck and hope you feel better very soon!

[m.ninehouser]

thanks so much. i really appreciate all of your words and advice. i will update you in the future. unless the migraines settle down for some reason on their own, i will most likely seek the aid of medication rather soon. it's nice to know now that effexor was most likely the reason my anxiety and migraines were so good for nearly 5 years. it's kind of like i have a worst case scenario button i can push if i must. thanks again!

-m.

[clinicalguru3]

.