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. 2024 Feb;44(2):3331024231222923.
doi: 10.1177/03331024231222923.

Improvement of migraine depressive symptoms is not related to headache frequency: exploring the impact of anti-CGRP therapies

Marta Torres-Ferrús  1   2 , Victor J Gallardo  2 , Alicia Alpuente  1   2 , Edoardo Caronna  1   2 , Eulalia Giné-Ciprés  1   2 , Patricia Pozo-Rosich  1   2
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Free article

Improvement of migraine depressive symptoms is not related to headache frequency: exploring the impact of anti-CGRP therapies

Marta Torres-Ferrús et al. Cephalalgia. 2024 Feb.
Free article

Abstract

Background: The present study aimed to describe the prevalence and evolution of depressive symptoms in a cohort of migraine patients treated with anti-CGRP monoclonal antibodies.

Methods: This is an exploratory, prospective, unicentric, one-year longitudinal study. We included migraine patients who started treatment with anti-CGRP monoclonal antibodies. Baseline demographic data, medical history, concomitant medication and migraine characteristics were collected. The presence of depressive symptoms was evaluated using the Beck Depression Inventory-II quarterly and treatment response was categorized according to the reduction in monthly headache days. A generalized mixed-effect regression model was used to model depression score over a one-year treatment taking into account frequency response rates.

Results: We included 577 patients: 84.2% females; median (range) age 47.0 (39.0-53.0) years, 46.1% (266/577) of them presented depressive symptoms at baseline (16.1% mild, 13.3% moderate and 16.6% severe). After six-month treatment, 47.4% (126/266) reduced headache frequency ≥50% after one year and 63.5% (169/266) achieved a clinically significant improvement in depression symptoms. We observed a 30.8% (-50.0%, -3.2%) main reduction in depression score during the first quarter. The improvement in depression symptoms was independently associated with headache frequency response: non-responders, -25.0% (-43.9%, -1.1%); partial responders, -30.2% (-51.3%, -7.6%); and good responders, -33.3% (-54.6%, -7.5%).

Conclusions: Anti-CGRP monoclonal antibodies targeting CGRP are effective in reducing depressive symptoms in patients with migraine. The main change of depression score happens during the first three months of treatment. The reduction in depressive symptoms is independent of migraine frequency improvement.

Keywords: CGRP; Calcitonin gene-related peptide; depression; migraine prevention; monoclonal antibodies; treatment.

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Conflict of interest statement

Declaration of conflicting interestsMT-F has received honoraria as a consultant or speaker for Allergan-Abbvie, Almirall, Chiesi, Eli Lilly, Novartis, Teva and Medlink. VJG has received honoraria as speaker for Eli Lilly and Novartis. AA has received honoraria as a consultant from Allergan-Abbvie, Novartis, Chiesi and Medlink. EC-G has received honoraria from Eli Lilly, Novartis and Teva. EC has received honoraria as consultant or speaker for Novartis, Chiesi and Medlink. In the last five years, PP-R has received honoraria as a consultant and speaker for: Abbvie, Amgen, Biohaven, Chiesi, Eli Lilly, Lundbeck, Medscape, Novartis and Teva. Her research group has received research grants from AbbVie, Novartis and Teva; and has received funding for clinical trials from Alder, Abbvie, Amgen, Electrocore, Eli Lilly, Lundbeck, Novartis and Teva. She is the Honorary Secretary of the International Headache Society. She is in the editorial board of Neurologia, and Revista de Neurologia, associate editor for Cephalalgia, Headache and The Journal of Headache and Pain. She is a member of the Clinical Trials Guidelines Committee and Scientific Committee of the International Headache Society. She has edited the Guidelines for the Diagnosis and Treatment of Headache of the Spanish Neurological Society. She is the founder of www.midolordecabeza.org. PP-R does not own stocks from any pharmaceutical company.

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