Preventive effect of citalopram on migraine headaches: a double-blinded randomized clinical trial

Objective: The aim of this study was to evaluate the effect of citalopram on the prevention of migraine headaches as compared to placebo. Materials and Methods: This double-blind randomized clinical trial was conducted on patients diagnosed with migraine headaches based on the guidelines of the International Headache Society. 226 patients who met inclusion criteria were randomly allocated to two control and intervention groups. The treatment group was treated with citalopram 30 mg daily for two months and the control group was given placebo the same amount as the treatment group. All the patients were assessed at the beginning of the trial and after 1 month and 2 months and the frequency, severity and duration of their headaches were documented using the Visual Analogue Scale (VAS) and Behavioral Rating Scale (BRS-6). Data were analyzed using SPSS v.16 software.    Results: Even though initially there was no statistically significant difference between the two groups regarding the severity, duration and frequency of episodes of migraine (P>0.05), the same parameters had drastic changes after the first and second months of treatment and the differences between the citalopram and placebo group regarding severity, duration and frequency of migraine episodes were statistically significant (P<0.05). Conclusion: The outcome of this experiment showed that citalopram, a serotonin uptake inhibitor (SSRI), possibly through a serotonin-lowering mechanism, results in less exposure of the CNS to this agent, leading to less frequent, less severe and shorter migraine episodes. This medication appears to be useful as a preventive drug used to treat and maintain episodes of migraine headaches, especially in individuals suffering from both migraine headaches and clinical depression.