Anxiety, depression and migraine comorbidity: A literature review

This article discusses the relationship between depression, anxiety, and migraine. Several studies have reported that the interrelationships between these disorders are bidirectional (e.g., depression can lead to migraine, and vice versa). However, the physiological mechanism underlying the association between migraine, anxiety and depression is not well understood. Understanding the relationship between depression, anxiety, and migraine may better enhance treatment plans for patients with these disorders. This article suggests a number of possible mediating factors that may predict the comorbidity of migraine and anxiety and/or depression, including substance abuse, cigarette smoking, obesity, adverse childhood experiences, and iron deficiency. Further, in this article, we explore the efficacy of two treatments-onabotulinumtoxinA and Erenumab-which have been shown to manage migraine, anxiety and depression. Our review suggests that it is important to understand the association between migraine, anxiety and depression as these disorders can lead to severe personal and economic negative outcomes, including pain medication dependency, reduced quality of life, reduced career success, and suicidal ideation.