My doctor prescribed an antidepressant for my migraines. Is this an appropriate migraine treatment? I don't have depression.

Answers from Jerry W. Swanson, M.D.

Certain antidepressants can help reduce the frequency and severity of some types of headaches, including migraines. You don't have to have depression to benefit from these drugs.

Tricyclic antidepressants, such as amitriptyline, are most effective and likely work by affecting the level of serotonin and other chemicals in your brain. There is little evidence that other classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), are effective for migraine prevention. However, preliminary research suggests that one SNRI, venlafaxine (Effexor), may be helpful in preventing migraines.

Side effects of antidepressants vary from one medication to another and from person to person, but they can include weight gain, fatigue, constipation and dry mouth. Such side effects can make it difficult to stick with treatment.

If the medication doesn't seem to be working or is causing bothersome side effects, discuss this with your doctor. Don't stop taking a prescribed medication without talking to your doctor first.

June 27, 2012