[Migraine and psychiatric disorders].
BACKGROUND
Migraine, mood disorders and anxiety disorders are common afflictions in the general population, with similar life-time prevalence rates, 10-20%. These disorders share many clinical features and the pathogenetic mechanisms may possibly be similar.


METHODS
This review is based on Medline searches for relevant literature.


RESULTS
Migraine typically occurs in the form of attacks. Panic disorder, the anxiety disorder most strongly linked to migraine, also occurs in attacks. Mood swings, both depressive and hypomanic, are often of short duration in many patients and can last only a couple of days; hence the course of these disorders has more similarities than is usually appreciated. Psychiatric symptoms are often seen in the course of a migraine attack. Epidemiological studies have shown strong comorbidity between these disorders. Migraine patients have higher prevalence of both anxiety disorders and depressions. There seems to be a particularly strong association between bipolar II disorder and migraine. Disturbances in monoaminergic systems, primarily the serotonergic, may represent pathophysiological mechanisms with regard to migraine and mood and anxiety disorders. Some drugs are effective in the treatment of all these disorders; the most important drugs are tricyclic antidepressants and valproate.


CONCLUSIONS
There are clear connections between migraine and psychiatric disorders and the attending physician should have them in mind.
Fasmer
Ole Bernt
OB
Psykiatrisk institutt, Universitetet i Bergen, Haukeland Universitetssykehus, 5021 Bergen. ole.fasmer@psyk.uib.no
Oedegaard
Ketil Joachim
KJ
D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000150:complications; D015897:Comorbidity; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D011954:Receptors, Dopamine / Q000187:drug effects / Q000502:physiology; D011985:Receptors, Serotonin / Q000187:drug effects / Q000502:physiology; D013315:Stress, Psychological / Q000150:complications; D014635:Valproic Acid / Q000627:therapeutic use
D000928:Antidepressive Agents; D018692:Antimanic Agents; D011954:Receptors, Dopamine; D011985:Receptors, Serotonin; D014635:Valproic Acid