Comparison between the effect of Nortriptyline and Venlafaxine on Prevention of Migraine

Background and Objective: Considering the lack of definitive treatment for migraine headaches and its high prevalence and high rates of disability, this study aimed to compare the effects of venlafaxine and nortriptyline on the prevention of migraine headaches. Materials and Methods: In this double-blind randomized clinical trial 201 patients with diagnosis of migraine based on IHS were randomly divided into two groups. The first group was treated with nortriptyline with a dose of 25 mg daily and the second group was treated with venlafaxine 37.5 mg twice daily for 3 months. All patients were evaluated for the frequency, duration and severity of pain in the beginning of study and at the end of 45 days and 90 days. Visual analogue scale (VAS) and 6 point behavioral rating scale (BRS-6) were used for evaluation of the severity of pain.Findings: Both drugs managed to significantly decrease the duration, frequency and severity of headaches based on VAS and BRS-6 at two intervals of 45 and 90 days after the intervention (P < 0.0001). The frequency of headache after 90 days of treatment with venlafaxine was significantly lower than that of nortriptyline (P = 0.01). In other cases, including the duration and severity of headache, there was no significant differences between the two groups (P > 0.05). Although vanlafaxine was more successful in reducing the frequency and nortriptyline in reducing the duration and severity of headache according to BRS-6, this difference was not statistically significant (P > 0.05). In addition, the study showed that both drugs after 3 months had a 100% success rate in reducing severity of headache according VAS. Conclusion: Both venlafaxine and nortriptyline have a proper prophylactic effect on patients with migraine, but there is no significant difference between this two medications.

Keywords:

Migraine , Nortriptyline , Venlafaxine , Prevention