The older class of tricyclic antidepressants are more effective at reducing the number and intensity of tension-type headaches and migraines than the newer selective serotonin reuptake inhibitor (SSRI) antidepressants, according to research published in the British Medical Journal. Tricyclic antidepressants have been used to prevent headaches since the 1960s.

Tricyclic antidepressants help to preserve catecholamines* in the brain. They include amitriptyline (Elavil®), protriptyline (Vivactil®), nortriptyline (Pamelor®), imipramine (Tofranil®), desipramine (Norpramin® and Pertofrane®), and doxepin (Sinequan®). These medications are often used in patients who experience frequent, daily or near-daily headaches.

Amitriptyline is included in a group of medications classified as tricyclic antidepressants. Amitriptyline is one of the first successful medications in this class to be developed. It was discovered in the late 1930s before scientists had today’s understanding of the chemistry of the brain. This drug was developed as a way to reduce anxiety. Frequently, people with depression are often very anxious. When amitriptyline was given to patients with anxiety, it also improved the depression. This result prompted further research and the development of newer agents to treat depression. As scientific understanding of the brain progressed, scientists discovered that amitriptyline and related compounds worked on a series of chemicals called neurotransmitters. The antidepressants influenced the production and efficiency of these neurotransmitters.