Migraine has been linked to depression and anxiety and they often co-exist. Together they increase the frequency and severity of headaches. According to a study presented at the recently concluded 2021 online Psych Congress, treatment with the antimigraine drug fremanezumab may help to wean off antidepressant medications in patients with migraine and concurrent depression and anxiety.

The study included 172 patients with migraine (chronic or episodic) and who had comorbid depression, 180 patients with comorbid anxiety and 142 patients with comorbid hypertension from 2014 to 2019. Over two-thirds of participants in all the three groups were female. The study duration was six months.  

Treatment with fremanezumab reduced the percentage of people using an antidepressant by 12.2%, from 68% at baseline compared to 56.4% at the end of the six months. The decline in antidepressant use was predominantly seen in patients with episodic migraine, from 74.8% at the time of study entry to 62.1%. Patients with chronic migraine also reduced their use of antidepressants after treatment with fremanezumab (59.4% vs 47.8%).

Similarly, patients with comorbid anxiety were also able to reduce the use of anxiolytics by 7.6% in those with episodic migraine and 8.1% in patients with chronic migraine. However, no significant changes were seen in systolic and diastolic blood pressures in migraine patients with comorbid hypertension after fremanezumab treatment during the 6-month follow-up.

Fremanezumab is a fully humanized monoclonal antibody, which acts against calcitonin gene-related peptide (CGRP) to prevent migraine. It was approved by the US FDA in for the prevention of migraine in adults in 2018. CGRP has been implicated in the pathophysiology of migraine.

Source: Medpage Today, November 1, 2021