This article appears in today's BMJ and can be viewed here. The review exmined 37 trials and concluded:
"Tricyclic antidepressants are effective in preventing migraine and tension-type headaches and are more effective than selective serotonin reuptake inhibitors, although with greater adverse effects. The effectiveness of tricyclics seems to increase over time."
One note of caution, the editorial points out:
"Conclusions that can be drawn from meta-analyses depend on the number and quality of available trials. As the authors rightly point out, the number of studies was not large and most were small and of short duration (average 11 weeks). Moreover, most trials would not meet current methodological standards because 80% (16/20) of placebo controlled trials were completed at least 20 years ago. As a result, convincing evidence is available for only the most general conclusion: amitriptyline is more effective than placebo for migraine and tension headache. Amitriptyline also seems to be more effective than serotonin reuptake inhibitors, although few direct comparisons are available."
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