Abstract
Depressive disorders are currently diagnosed based on the ICD-10 and DSM-5 diagnostic criteria and include axial depressive symptoms and additional symptoms that must coexist for at least two weeks. Migraine is diagnosed based on the International Classification of Headache Disorders. It is generally divided into migraine with and without aura, and with regard to the frequency of attacks into episodic and chronic migraine. The therapeutic strategy in the treatment of depression is pharmacotherapy combined with psychotherapy, whereas in the treatment of migraine the strategy depends on the frequency of headache attacks (episodic migraine vs. chronic migraine) and comorbidities. A novelty is the introduction of monoclonal antibodies directed against CGRP or the receptor of CGRP. There are numerous reports which indicate specific usefulness of monoclonal antibodies that modify the action of CGRP in the treatment of migraine in people suffering from depression.
Highlights
Major depressive disorders (MDDs) are the most common condition observed in patients with migraine [1,2,3], and the risk of MDD in migraine headache sufferers exceeds the population risk [4].The standard approach to the management of migraine, before starting pharmacological or non-pharmacological treatment, is the correct diagnosis of the disease [5], followed by a detailed discussion with the patient about the nature of the disease and the planned management
Prophylactic treatment of chronic migraine is somewhat different than in episodic migraine, as three agents are recommended in class A: two oral antiepileptics [35], i.e. valproic acid at a daily dose of 500-1500 mg and topiramate at a daily dose of 25200 mg, and botulinum toxin injections at a dose of 150-195 U every 12 weeks (A/B) [47]
In depressed patients treated with antidepressants from the group of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), the use of triptans for short-term treatment of a migraine attack may cause symptoms of serotonin syndrome
Summary
Depressive disorders are currently diagnosed based on the ICD-10 and DSM-5 diagnostic criteria and include axial depressive symptoms and additional symptoms that must coexist for at least two weeks. Migraine is diagnosed based on the International Classification of Headache Disorders. It is generally divided into migraine with and without aura, and with regard to the frequency of attacks into episodic and chronic migraine. The therapeutic strategy in the treatment of depression is pharmacotherapy combined with psychotherapy, whereas in the treatment of migraine the strategy depends on the frequency of headache attacks (episodic migraine vs chronic migraine) and comorbidities. A novelty is the introduction of monoclonal antibodies directed against CGRP or the receptor of CGRP. Indicate specific usefulness of monoclonal antibodies that modify the action of CGRP in the treatment of migraine in people suffering from depression
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