Does desvenlafaxine help with migraines? (+3 treatments)

In this article, we will discuss whether desvenlafaxine helps with migraines. We will also discuss the mechanism through which desvenlafaxine helps with migraine and share evidence from literature and other relevant information. 

Does desvenlafaxine help with migraines? 

Desvenlafaxine may or may not help with migraine. The evidence on the efficacy of desvenlafaxine in migraines is scarce. However, different antidepressants like desvenlafaxine have been used in the prophylactic management of migraines. 

Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) and an antidepressant. It is an FDA-approved drug to treat major depressive disorder (MDD). It increases serotonin and norepinephrine (NE) levels in the brain (1). 

Although desvenlafaxine is not prescribed for the management of migraines, research suggests that drugs belonging to the class of SNRIs like venlafaxine are used to prevent migraines (2). 

Desvenlafaxine is an active metabolite of venlafaxine. It means that venlafaxine converts to desvenlafaxine in the body. As venlafaxine is effective in managing migraines, it can be assumed that desvenlafaxine may also help with migraines. 

It is important to note that desvenlafaxine is not specifically prescribed for migraines. It means that you cannot take desvenlafaxine only for migraines. Desvenlafaxine may help with migraines in patients with depression. 

What are the symptoms of migraine? 

Migraines are characterized by recurrent, moderate-to-severe throbbing headaches that can last for hours to days. Migraines are commonly associated with the following symptoms (2): 

• pulsating pain which is usually on one side of the head
• increased sensitivity to light and sound
• nausea

Some migraines are associated with visual, motor, sensory, or retinal disturbances and are termed as migraine with aura (2). If you experience the symptoms of migraine, you must communicate it with your healthcare provider.

How can desvenlafaxine help with migraine? 

Desvenlafaxine blocks the reuptake of serotonin and NE which increases their concentration in the brain. Different neurotransmitters including serotonin and NE influence pain transmission in the central nervous system (CNS). 

The controversial role of serotonin in migraines: 

The role of serotonin in the development of migraines is a matter of controversy. Evidence suggests that migraines are associated with a deficiency of serotonin. It is assumed that serotonin levels are low during migraine attacks (2).

Low serotonin levels cause a deficit in the serotonin pain inhibition system and activate the trigeminal system which promotes pain transmission, vasodilation, and inflammation (2). 

The role of serotonin deficit in migraines is further supported by the fact that drugs increasing serotonin levels like venlafaxine, Celexa, and amitriptyline help prevent migraine. 

However, some studies have also demonstrated that migraine patients present with increased serotonin levels between attacks. Thus migraine patients may have raised serotonin which facilitates pain transmission (3). 

Thus, serotonin’s role in migraine needs further investigation. Similarly, whether desvenlafaxine works for migraine or not also needs further exploration. However, as per the current research, drugs similar to desvenlafaxine help in migraines. 

What does research suggest? 

Research on the efficacy of desvenlafaxine in reducing migraines is scarce. However, other SNRIs have shown some efficacy in preventing migraines. Duloxetine, venlafaxine, and desvenlafaxine are classified as SNRIs. 

One review was conducted to summarize the use of antidepressants in preventing migraines. The results concluded that SNRIs like venlafaxine and duloxetine are effective in migraine prevention, especially in depressed patients (4). 

In another study, the efficacy of venlafaxine and amitriptyline in preventing migraines was evaluated. Results demonstrated that venlafaxine was effective and associated with fewer side effects than amitriptyline in migraine prophylaxis (5). 

An 8-week study on duloxetine revealed that it is effective and well-tolerated in the management of patients who have depression and chronic headaches (6). 

Thus, the evidence on the efficacy of desvenlafaxine in migraines is obscure. However, due to the efficacy of drugs similar to desvenlafaxine in preventing migraines, it can be assumed that desvenlafaxine might also be helpful. 

How can you take desvenlafaxine for migraines? 

Desvenlafaxine is a prescription medication and should not be used if not prescribed by a healthcare provider. It cannot be taken just for migraines until advised by the healthcare provider. 

Your healthcare provider may prescribe desvenlafaxine if you have MDD. Desvenlafaxine might help with migraines that occur along with depression. Thus, you should not self-medicate if you experience migraine attacks. 

If you take desvenlafaxine for conditions it is known to treat, take it exactly as prescribed by your healthcare provider. You take it at any time of the day with or without food. Do not cut the tablet in half and do not stop taking it abruptly (1). 

Desvenlafaxine is initially prescribed at the dose of 50mg/day. It is effective and well-tolerated at this dose. The highest dose that can be prescribed per day is 400mg (1). 

What are some other ways to treat migraines? 

Desvenlafaxine may or may not help with migraines. Antidepressants are preferred for migraines in patients who also have depression or anxiety disorders. Well-known treatments for migraine are as follows (2): 

Treatment to stop migraines: 

Different medications can be used to stop migraines quickly and manage other symptoms. However, their use should be limited and recommended by the healthcare providers. The medications include (2): 

• NSAIDS
• triptans
• antiemetics like metoclopramide
• lasmiditan

Treatment to prevent migraines: 

Preventive treatment lowers the frequency of migraine attacks and improves how well someone responds to the attacks. Preventive treatment is recommended in specific conditions therefore the guidance of healthcare providers is important (2). 

Preventive treatment for migraines includes the following (2): 

• beta-blockers like metoprolol and propranolol 
• antidepressants like amitriptyline and venlafaxine
• anticonvulsants like valproate acid and topiramate
• calcium channel blockers like verapamil and flunarizine 

Alternative treatments: 

Different lifestyle modifications can help you to manage your migraines. You can document your triggers for migraine and try to avoid them to reduce migraine attacks (2). Your sleeping patterns and meals must be consistent. 

Regular physical activity and yoga are also effective in reducing migraine frequency. You can also practice relaxation techniques to manage your stress because stress is a common trigger for migraines. 

Make sure to maintain adequate hydration as dehydration is also a trigger for migraines in some people. You can also get help from complementary therapies like bio-feedback therapy and cognitive behavioral therapy (2). 

What are some side effects of desvenlafaxine? 

If your healthcare provider has prescribed you desvenlafaxine, you can experience the following side effects (1): 

• headaches
• nausea
• reduced appetite
• abdominal pain 
• sweating 

It is important to remember that headaches caused by desvenlafaxine are not the same as migraines. The headaches are a side effect and are likely to go away once your body adjusts to the medication. 

Side effects of desvenlafaxine are likely to occur in the first week of treatment and resolve afterward. If you take higher doses of desvenlafaxine, you are likely to experience heightened side effects (7). 

In my perspective, desvenlafaxine may or may not help with migraines. Its efficacy in treating migraines has not been established in the literature. Desvenlafaxine is not an approved treatment for migraines. However, antidepressants like desvenlafaxine including venlafaxine and duloxetine have shown efficacy in preventing migraines. These antidepressants work by increasing serotonin levels and a serotonin deficit is likely to be related to migraines. Through similar mechanisms, it can be assumed that desvenlafaxine might also help with migraines. However, it cannot be taken solely to manage migraines and it should be prescribed by a healthcare provider for conditions it is known to treat.

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