Does Lexapro help with vestibular migraine? (+3 tips)

This article will explore whether Lexapro can be used to manage vestibular migraines. It will also discuss the ways Lexapro may help with vestibular migraines by increasing serotonin levels in the brain.

Additionally, the article will address the potential side effects of Lexapro and offer alternative management strategies for those for whom the medication may not be effective. 

Does Lexapro help with vestibular migraine?

Yes, Lexapro may help with vestibular migraines in some people. However, it is not approved by the FDA for this condition [1]. Many people have reported that the off-label use of selective serotonin reuptake inhibitors, including Lexapro, has helped with their vestibular migraine.

Lexapro can especially help in managing vestibular migraines in people who are also suffering from depression or anxiety. However, it’s essential to note that the effectiveness of Lexapro or any other medication can vary from person to person.

Thus, it is crucial to consult with a healthcare professional for a proper selection of treatment options for vestibular migraines.

How can Lexapro help with vestibular migraine?

Lexapro (escitalopram), a selective serotonin reuptake inhibitor (SSRI), can potentially help with vestibular migraines and painful attacks by increasing the availability of serotonin in the brain [2,3].

To illustrate, vestibular migraine attacks often involve imbalanced serotonin levels, which can lead to vasodilation of cranial arteries and result in painful headaches [2].

By increasing serotonin in the brain, Lexapro can help restore vasoconstriction of cranial arteries, thereby reducing the severity and intensity of the headache associated with vestibular migraines [2,3]. Other SSRIs, like Celexa, can similarly help with migraines.

What does research suggest?

One study investigated the efficacy of escitalopram in the prophylaxis of migraine. Escitalopram significantly reduced the frequency, duration, and intensity of monthly headaches. After 3 months, 96.5% of the patients showed a successful response [4].

Furthermore, according to a study on the treatment of vestibular migraines, the treatment should be based on the comorbidities of the patient. To illustrate, for patients who also suffer from anxiety and depression, researchers recommended using SSRIs as the preferred treatment for vestibular migraines [5].

Another study states that for patients with vestibular migraine-anxiety-related dizziness (MARD) and increased anxiety symptoms, taking a selective serotonin reuptake inhibitor, like Lexapro, is the most recommended treatment [6].

What are the side effects of using Lexapro for vestibular migraine?

If one is considering using Lexapro for managing their vestibular migraine, it is important to understand its potential side effects. The most common Lexapro side effects include [3]:

• Sleepiness
• Excessive sweating
• Weight loss or weight gain
• Drowsiness
• Tiredness
• Blurry vision
• Dry mouth
• Insomnia

How to know if Lexapro is effective for your vestibular migraine?

To determine whether Lexapro has effectively helped with your vestibular migraine, there are various indications and symptoms to look for. These may be different for each individual, but here are some examples:

• Firstly, you may notice a reduction in the frequency and intensity of vertigo episodes and a decrease in the severity of the associated dizziness and spinning sensations.
• Improved stability and balance, especially while walking, standing, and performing everyday tasks, can be indicative of Lexapro’s effectiveness in managing your vestibular migraine.
• A decreased sensitivity to triggers that previously triggered migraines, such as sudden head movements, bright lights, or loud noises, indicates that Lexapro is assisting in the management of your vestibular migraines.
• Furthermore, a reduction in nausea and vomiting, which often accompany vestibular migraines, can be a sign of Lexapro’s efficacy.
• Finally, if Lexapro is helping with your vestibular migraines, you may experience an increase in energy levels and notice an improved ability to participate in social activities, work, and hobbies that were affected by these migraines.

What to do if Lexapro isn’t effective for your vestibular migraine?

If Lexapro is not effective in treating your vestibular migraine, there are several management strategies that you can discuss with your doctor. For instance, they may consider adjusting the dosage of Lexapro, adding another medication, or switching to a different medication within the same class or a different class. 

Here are some other possible management strategies: 

Consider other drugs

To enhance the treatment of vestibular migraines, the doctor may suggest taking a beta-blocker, a tricyclic antidepressant, a serotonin-norepinephrine reuptake inhibitor (like venlafaxine), a triptan, or an antiepileptic drug (like valproic acid, lamotrigine, or topiramate) [5].

Aim for a healthier lifestyle

Furthermore, practicing good sleep hygiene, managing stress levels, avoiding trigger factors such as certain foods, caffeine, and alcohol, and maintaining a regular exercise routine can help reduce the frequency and intensity of vestibular migraines.

Consider complementary or alternative therapy

Some individuals may find complementary and alternative therapies such as acupuncture, biofeedback, or relaxation techniques helpful. You can discuss these options with your doctor.

What other drugs are effective for vestibular migraine?

Various drugs and treatments have been found effective in managing vestibular migraine, aside from Lexapro.

For acute attacks, abortive treatments can be administered to relieve pain. It is important to mention that these drugs shouldn’t be used for more than 10 days per month. They include painkillers like NSAIDs and triptans for headache relief [5].

Moreover, cyclizine, prochlorperazine, and cinnarizine can help with vertigo symptoms like dizziness, lightheadedness, and balance problems. Lastly, anti-emetics like prochlorperazine, cyclizine, cinnarizine, or domperidone can be used to manage nausea associated with acute attacks of migraines [5].

Furthermore, when it comes to prophylactic treatments, tricyclic antidepressants like amitriptyline and nortriptyline have shown good efficacy, especially for comorbid pain or insomnia. Propranolol, which is a beta-blocker, is also widely used as an effective prophylactic drug [5].

Other options that are also effective for preventing migraine episodes but have a higher risk of adverse effects include topiramate, sodium valproate, and venlafaxine. Finally, lamotrigine can be considered only if other preventive medications don’t work [5].

Based on my research, I concluded that Lexapro may help with vestibular migraines in some individuals, particularly those with comorbid depression or anxiety. However, Lexapro is not FDA-approved for this specific condition. 

Studies have shown promising results regarding the efficacy of escitalopram in reducing the frequency, duration, and intensity of monthly headaches in vestibular migraines.

In my perspective, it is crucial to be aware of the potential side effects of Lexapro, including sleepiness, excessive sweating, weight changes, drowsiness, blurry vision, dry mouth, and insomnia.

If Lexapro is not effective in treating vestibular migraines, I recommend consulting with your doctor, adjusting medication dosage, adding complementary drugs, or switching to different medications. I additionally believe that practicing a healthier lifestyle can also be beneficial.

References