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Miagraines and Psychiatric Disorders

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Migraines and Psychiatric Disorders

Tidsskr Nor Laegeforen 2004 Sep 23;124(18):2350-3

Fasmer OB; Oedegaard KJ

Psykiatrisk institutt, Universitetet i Bergen, Haukeland Universitetssykehus, 5021 Bergen. ole.fasmer@psyk.uib.no.

BACKGROUND: Migraine, mood disorders and anxiety disorders are common afflictions in the general population, with similar life-time prevalence rates, 10-20%. These disorders share many clinical features and the pathogenetic mechanisms may possibly be similar.

MATERIAL AND METHODS: This review is based on Medline searches for relevant literature.

RESULTS: Migraine typically occurs in the form of attacks. Panic disorder, the anxiety disorder most strongly linked to migraine, also occurs in attacks. Mood swings, both depressive and hypomanic, are often of short duration in many patients and can last only a couple of days; hence the course of these disorders has more similarities than is usually appreciated. Psychiatric symptoms are often seen in the course of a migraine attack. Epidemiological studies have shown strong comorbidity between these disorders. Migraine patients have higher prevalence of both anxiety disorders and depressions. There seems to be a particularly strong association between bipolar II disorder and migraine. Disturbances in monoaminergic systems, primarily the serotonergic, may represent pathophysiological mechanisms with regard to migraine and mood and anxiety disorders. Some drugs are effective in the treatment of all these disorders; the most important drugs are tricyclic antidepressants and valproate.

INTERPRETATION: There are clear connections between migraine and psychiatric disorders and the attending physician should have them in mind.

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