Tricyclic antidepressants

Your doctor may prescribe a tricyclic antidepressant to help prevent your headaches. These drugs have been shown to be effective in preventing both migraine and tension-type headaches. They work by increasing the levels of the neurotransmitters serotonin and norepinephrine within the brain.

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Generic and brand names of some tricyclic antidepressants used for headaches include amitriptyline (Elavil), desipramine (Norapramin, Pertofrane), doxepin (Sinequan, Adapin), imipramine hydrochloride (Tofranil, Janimine), nortriptyline (Pamelor, Aventyl).

The doses of tricyclic antidepressants used to prevent headaches are much lower than those used to treat depression. However, this drug might have beneficial effects on mood, sleep, appetite, libido, and memory, in addition to controlling your headaches. This drug is taken at night to prevent daytime drowsiness. This drug usually takes three to six weeks to become effective. Therefore, you should take it for at least two months to determine its effectiveness. Your dosage will be determined by your doctor.

Side effects are common during the first two weeks of treatment, then usually subside. They include constipation, dry mouth, and sedation and are more common with amitriptyline than with other tricyclic antidepressants, especially in the elderly population.

If you experience blurred vision, rapid heartbeat, orthostatic hypotension (a drop in blood pressure and a feeling of dizziness when you stand up quickly), or difficulty urinating, call your doctor. Before taking the drug, tell your doctor if you have narrow-angle glaucoma or a history of heart disease, kidney disease, thyroid problems, or seizures. Also, notify your doctor if you have taken an MAO inhibitor, such as Nardil, within the past 14 days.