Antidepressant medicines, which are usually used to treat depression, can be effective in preventing chronic tension headaches. Antidepressants have some pain-relieving properties and may reduce how often headaches occur and how long they last. Antidepressants are also used to improve sleep problems.
Tricyclic antidepressants, such as amitriptyline, are the antidepressants used most often to reduce the frequency or duration of tension headaches.
Medicines to prevent tension headaches have not been well studied. The best evidence is for amitriptyline. It has been proven to reduce how often tension headaches occur and how bad they get.footnote 1 If you do not respond well to amitriptyline, you may try other tricyclic antidepressants, although they may not work as well to relieve your headache.
Side effects of tricyclic antidepressants include:
Drowsiness or sleepiness.
Inability to urinate.
Low blood pressure when you stand up quickly.
Other antidepressants used to prevent tension headaches include mirtazapine (Remeron) and venlafaxine (Effexor).
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
Jackson JL, et al. (2010). Tricyclic antidepressants and headaches: Systematic review and meta-analysis. BMJ. Published online October 20, 2010 (doi:10.1136/bmj.c5222).