Pharmacological management of mood and anxiety disorders in headache patients.
There is emerging evidence that treatment of comorbid mood and anxiety disorders can improve headache treatment outcome when implemented within a comprehensive program. Effective treatment for comorbid mood and anxiety disorders requires screening headache patients and accurately diagnosing specific psychiatric disorders when present. Specific dual-action antidepressant, anticonvulsant, and atypical antipsychotic medications can serve as dual agents that simultaneously treat both headaches and a mood or anxiety disorder. Serotonin reuptake inhibitors and most other antidepressant, anxiolytic, and mood-stabilizing medications are generally ineffective for headache prophylaxis. However, they can be safely added to a headache regimen for treatment of a comorbid psychiatric disorder. Treatment of comorbid psychiatric disorders in headache patients requires patient education about the psychiatric disorder, its treatment, possible side-effects, and expected benefits. Clinicians need to be sensitive to possible stigma that some patients fear from a psychiatric diagnosis or its treatment.
Griffith
James L
JL
Department of Psychiatry and Behavioral Sciences, The George Washington University Medical Center, Washington, DC 20037, USA.
Razavi
Maryam
M
D001008:Anxiety Disorders / Q000150:complications* / Q000188:drug therapy*; D006261:Headache / Q000150:complications*; D006801:Humans; D019964:Mood Disorders / Q000150:complications* / Q000188:drug therapy*