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Efficacy of Duloxetine as a Migraine
Preventive Medication: Possible Predictors of
Response in a Retrospective Chart Review
Anne Taylor, James Adelman, Marshall Freeman
Posted: October 2007  
Headache 2007;47:1200-1203

Objective:   This case series is a retrospective chart analysis conducted to evaluate the efficacy of duloxetine as a migraine preventive medication and to suggest possible predictors of response.

Background:   Duloxetine, a relatively new selective serotonin and norepinephrine reuptake inhibitor, is FDA-approved for treatment of depression and diabetic peripheral neuropathic pain. The efficacy of duloxetine as a headache preventive medication is currently unknown.

Method:   A retrospective chart review was performed using the electronic medical records of Headache Wellness Center, a headache specialty practice in Greensboro, NC. From January 2004 to December 2006, 65 patients were identified who were prescribed duloxetine for migraine prevention for at least 2 months. Doses ranged from 30mg. a day to 90 mg. a day. Frequency, severity, and impact of migraine disability were measured at baseline and compared to values obtained after 2 months of treatment.

Conclusions:   Duloxetine demonstrates minimal effectiveness as a headache preventive medication. An interesting trend suggests that the presence of anxiety may be a positive predictor in treatment with duloxetine.