From the Guidelines
Lexapro can potentially trigger migraines in some individuals, though it is not a common side effect, and the exact relationship between Lexapro and migraines is not well-established in the provided evidence. The provided guideline evidence [ 1 ] focuses on the management of headache, including migraine prevention and treatment, but does not specifically address the question of whether Lexapro causes migraines. However, it does discuss various medications for migraine prevention and treatment, which may be relevant for patients experiencing migraines while taking Lexapro. Some key points from the guideline evidence include:
- Recommendations for migraine prevention, such as candesartan or telmisartan [ 1 ], and erenumab, fremanezumab, or galcanezumab [ 1 ]
- Suggestions for migraine prevention, including lisinopril [ 1 ], oral magnesium [ 1 ], topiramate [ 1 ], propranolol [ 1 ], and valproate [ 1 ]
- Recommendations for abortive migraine treatment, such as eletriptan, frovatriptan, rizatriptan, sumatriptan, and zolmitriptan [ 1 ], as well as aspirin-acetaminophen-caffeine [ 1 ] If you're experiencing migraines after starting Lexapro, it's essential to discuss this with your healthcare provider, as they can help determine the best course of action, which may include adjusting your dosage or switching to a different medication. It is crucial to prioritize morbidity, mortality, and quality of life when making decisions about Lexapro and migraine management.
From the Research
Migraine and Lexapro
- Lexapro, also known as escitalopram, is a selective serotonin reuptake inhibitor (SSRI) that has been studied for its potential role in migraine prevention 2, 3.
- According to a study published in 2009, escitalopram was found to be effective in reducing migraine frequency, duration, and intensity in patients without depression or anxiety 3.
- However, another study published in 2015 found that SSRIs, including escitalopram, were not more effective than placebo or amitriptyline in reducing migraine frequency, intensity, and duration 2.
- A review published in 2019 stated that SSRIs, including fluoxetine, are not effective for most patients with migraine, but SNRIs such as venlafaxine and duloxetine may be effective in patients with comorbid depression and migraine 4.
Side Effects and Considerations
- Escitalopram was found to have fewer side effects compared to venlafaxine, making it a potential first-choice option for migraine prevention 3.
- The use of antidepressants, including SSRIs and SNRIs, for migraine prevention can have a substantial side effect burden, and patients should be counseled about the possibility of withdrawal effects 4.
Comparison to Other Treatments
- The effectiveness of escitalopram and other SSRIs in migraine prevention is still a topic of debate, and more research is needed to fully understand their role in treating migraine 2, 4.
- Other medications, such as amitriptyline, venlafaxine, and duloxetine, have been found to be effective in migraine prevention, and may be considered as alternative options 5, 6, 4.