Antidepressant medicines, which are usually used to treat
depression, can be effective in preventing chronic
tension headaches. Antidepressants have some
pain-relieving properties and may reduce how often headaches occur and how long
they last. Antidepressants are also used to improve sleep problems.
Tricyclic antidepressants, such as amitriptyline, are the
antidepressants used most often to reduce the frequency or duration of tension
Medicines to prevent tension headaches have not been well studied.
The best evidence is for amitriptyline.1 It has been
proved to reduce how often tension headaches occur and how long they
last.2 If you do not respond well to
amitriptyline, you may try other tricyclic antidepressants, although they may
not work as well to relieve your headache.
effects of tricyclic antidepressants include:
Inability to urinate.
Low blood pressure when you stand up quickly.
Other antidepressants used to prevent tension
headaches include mirtazapine (Remeron) and venlafaxine (Effexor).
FDA Advisory. The U.S. Food
and Drug Administration (FDA) has issued an
advisory on antidepressant medicines and the risk of
suicide. The FDA does not recommend that people stop using these medicines.
Instead, a person taking antidepressants should be watched for
warning signs of suicide. This is especially important
at the beginning of treatment or when the doses are changed.
Loder E, Rizzoli P (2008). Tension-type
headache. BMJ, 336(7635): 88–92.
Silver N (2006). Headache (chronic tension-type),
search date October 2005. Online version of Clinical Evidence (15).
How this information was developed to help you make better health decisions.