Migraine drug to reduce depressive symptoms in patients having both, finds study

A migraine drug has shown to significantly reduce symptoms of depression in patients—the first trial to show improvements in both the conditions using a single drug, researchers said.

In the study involving 540 patients, ‘fremanezumab’ was found to reduce days of migraine in a month and symptoms of depression, compared to a placebo (inactive substance producing no effects). The drug, administered as an injection beneath the skin (subcutaneous), is available in India.

Published in The Journal of the American Medical Association (JAMA) Neurology, the study is the first to demonstrate significant improvements in migraine and depressive symptoms—often seen to co-exist in patients—with a single drug, the researchers, including those from Albert Einstein College of Medicine, US, said.

Patients of migraine—a common neurological condition marked by recurring headaches—have been studied to be two to four times more likely to develop depression. The two conditions are suggested to have common genetic basis and biological processes that control levels of brain chemicals, such as serotonin and glutamine.

The researchers said that patients having migraine and depression are treated with antidepressants—which work by improving serotonin levels. Serotonin helps regulate mood, and low levels can cause sadness, anxiety and irritability.

However, antidepressants are not uniformly effective for migraine. Further, data is limited on the efficacy of migraine therapy in people also experiencing psychiatric conditions.

The trial was conducted over a 28-week period at 61 centres across 12 countries, including the US, UK, France, and Germany, between July, 2020, and August, 2022.

The participants were randomly assigned to receive a monthly dose of fremanezumab (225 milligrams) or a placebo at the study’s start and at the end of week four and week eight.

“Although treatment with fremanezumab and placebo both resulted in clinically meaningful reductions in depressive symptoms, fremanezumab achieved statistical significance vs placebo at week 8,” the authors wrote.

They suggested that the reduced depressive symptoms could be an indirect effect of the drug actively treating migraine, although further analyses are required to understand this.

The results “suggest that fremanezumab was effective in a difficult-to-treat clinical population with migraine and comorbid major depressive disorders and may also be effective in alleviating psychiatric comorbidities, therefore reducing the cumulative burden on patients.”