Venlafaxine extended release (XR) for the prophylaxis of migraine and tension-type headache: A retrospective study in a clinical setting

Objective.-To assess the efficacy of extended-release venlafaxine in the pr ophylaxis of migraine and chronic tension-type headache. Background.-Venlafaxine, a structurally novel antidepressant, is a selectiv e serotonin-norepinephrine reuptake inhibitor. This study is the first to t est the effects of extended-release venlafaxine on headaches. Methods.-Patients were evaluated on a retrospective basis. Fifty-six patien ts with chronic tension-type headache and 114 patients with migraine were p rescribed extended-release venlafaxine. Nearly all the study subjects had b een resistant to several previous preventive medications. Patients took ven lafaxine for an average of 6 months with a median dose of 150 mg (range, 37 .5 to 300 mg). Results.-The mean frequency of headaches in the group with chronic tension- type headache fell from 24.0 to 15.2 per month (P<.0001). The group with mi graine showed a reduction from 16.1 to 11.1 headaches per month (P<.0001). The medicine was well tolerated. Conclusions.-This trial indicates that extended-release venlafaxine has pot ential in headache prophylaxis based on its efficacy and safety profile. We recommend a double-blind, placebo-controlled study to further assess the r ole of extended-release venlafaxine in headache prevention.