Table 2.

Tricyclic antidepressants in migraine prophylaxis

Daily dose range (the most effective dose range is shown in parentheses) Amitriptyline hydrochloride (should be specifically considered as first-line agent): 10 to 300 mg (30-150 mg) Doxepin hydrochloride: 10 to 200 mg (50-150 mg) Imipramine hydrochloride: 10 to 200 mg (50-150 mg) Nortriptyline hydrochloride: 10 to 150 mg (50-150 mg) Protriptyline hydrochloride: 15 to 40 mg Side effects Anticholinergic effects (dry mouth, constipation, blurred vision) Sedation Postural hypotension Agitation Tremor Seizures Sexual dysfunction Weight gain Precautions Arrhythmias or cardiac conduction defects Urinary retention Angle closure glaucoma Seizures Obesity Pregnancy Concurrent monoamine oxidase inhibitor use Special indications Tension-type headaches Concurrent depression, insomnia, and chronic pain