Abstract Details

Title Comparative Efficacy and Safety of Tricyclic Antidepressants (TCAs) Versus Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) for Migraine Prophylaxis: A Systematic Review and Meta-Analysis

Topic Headache

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-004

Objective

We performed a systematic review and meta-analysis to evaluate the comparative efficacy and safety of TCAs versus SNRIs for migraine prophylaxis.

Background

Migraine is a leading cause of global disability, yet research on prophylactic interventions remains limited due to unclear underlying mechanisms. Recent trials comparing SNRIs and TCAs provide new hope for advancing prophylactic interventions, but data remain limited.

Design/Methods PubMed, Embase, Scopus, and Cochrane Central databases were searched to identify randomized controlled trials (RCTs) involving migraine patients and comparing SNRIs with TCAs. We applied a random effects model and pooled risk ratios (RRs) along with 95% confidence interval (CI) using RevMan 5.4. Quality assessment was performed using the Rob 2 tool.

Results

Three RCTs involving 333 patients (mean age 32.4 years, 68% female) with a mean follow-up of 10 weeks were included in the analysis. Migraine frequency (attacks per month) was comparable between the SNRI and TCA groups (MD = -0.03, 95% CI: -0.67 to 0.61; p = 0.93). However, patients receiving TCAs experienced slightly longer migraine attack durations compared to those on SNRIs (MD = 0.71, 95% CI: 0.01 to 1.41; p = 0.05). Additionally, adverse events were significantly fewer in the SNRI group than TCA group (RR = 1.47, 95% CI: 1.10 to 1.97; p = 0.009). All trials were rates as low risk.

Conclusions

SNRIs demonstrated comparable efficacy to TCAs in reducing migraine frequency, with shorter attack duration and fewer adverse events.

Authors/Disclosures
Advait Teli, MBBS PRESENTER	Dr. Teli has nothing to disclose.
Sufyan Shahid, MBBS	Mr. Shahid has nothing to disclose.
Abdullah Farooq, MBBS	Mr. Farooq has nothing to disclose.
Ayesha Batool, MBBS	Dr. Batool has nothing to disclose.
Umna N/A	Miss N/A has nothing to disclose.
Syed I. Ali, MBBS	Mr. Ali has nothing to disclose.
Humza Saeed, MBBS	Mr. Saeed has nothing to disclose.
Megha Joshi, MBBS	Dr. Joshi has received personal compensation for serving as an employee of Essen Healthcare. Dr. Joshi has received personal compensation for serving as an employee of CityMD. Dr. Joshi has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for SGS Consulting.
Japleen Kaur, MBBS	Dr. Kaur has nothing to disclose.

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