A pharmaco-epidemiological study of migraine and antidepressant medications: Complete one year data from the Norwegian population

Background: Migraine, depression and anxiety disorders have been associated with one another in several epidemiological studies. However, it is not known if or how these associations are reflected in the concurrent use of medications for migraine and depressive/anxiety disorders in the general population. The purpose of the present study was to identify groups of patients particularly likely to receive clinical treatment for both conditions. Methods: Data from the Norwegian Prescription Database for 2006 were analysed for the purpose of ascertaining concurrence of prescriptions for migraine and depression/anxiety disorders. Data were subjected to analysis testing deviation from unity for the OR performed by a chi-square test. Results: In the total Norwegian population (N=4640219) migraine drugs were prescribed to 81225 persons (1.8% of the population), antidepressant drugs to 257700 persons (5.6% of the population), and 11269 persons were prescribed both types of drugs. The prescription of antidepressants was significantly increased in patients receiving a prescription for a medication used to treat migraine (OR = 2.82 (95% CI = 2.76-2.88); chi-square p < 0.001), and this association was stronger for men than for women. Teenage women carried the highest risk for this co-morbid constellation (OR = 3.89 CI = 3.17-4.77); chi-square p < 0.001). Conclusion: This study revealed a strong positive association between the prescription of migraine and antidepressant medications, and this association was generally most pronounced in men. However, teenage girls carried the highest risk of receiving both kinds of prescriptions, suggesting particular attentiveness is required in the clinical management of these patients. (C) 2010 Elsevier B.V. All rights reserved.