Fluoxetine (Prozac) for Tension Headache

September 30, 2008

Fluoxetine belongs to a class of antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs), and is used to treat mental depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and premenstrual dysphoric disorder (PMDD). How fluoxetine and other antidepressants prevent tension-type headache is uncertain, but this type of drug has helped a variety of painful states including headache. Fluoxetine acts only on the neurotransmitter chemical, serotonin, and so may reduce the frequency of migraine by regulating serotonin levels in the brain. Side effects include anxiety, nervousness, decreased appetite, decreased sexual ability or drive, skin rash, diarrhea, drowsiness, increased sweating, nausea, tiredness, weakness, trembling, shaking, and difficulty sleeping, among others.

Researchers at the University College London Medical School in England compared the use of fluoxetine and desipramine (an antidepressant drug) in the treatment of chronic tension headache and depression. Patients received either fluoxetine or desipramine for 12 weeks. Of the 25 patients who completed the study, 12 received fluoxetine and 13 desipramine. Neither group showed a significant difference at the start of the study or in change of pain, reduction in the use of pain drugs, or changes in depression scores. However, 72% of patients who completed the study improved.

In a study published in Headache, prescriptions of newer antidepressants (venlafaxine) accounted for 15% of off-label drugs used for headaches. Researchers concluded that off-label drugs are reasonable for treating headache disorders.

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