Anti-CGRP monoclonal antibodies, migraine and mood disorders: an observational study.

Introduction: Migraine is frequently associated with psychiatric comorbidities, especially anxiety and depressive disorders, with related worse clinical outcome and chronicisation. Aim of the study was to assess the effectiveness of anti-CGRP antibodies in alleviating migraine-related symptoms and comorbid anxiety and depressive symptoms.

Methods: Retrospective observational study including 206 migraine out-patients in treatment with anti-CGRP antibodies. Beck Depression Inventory (BDI) scale assessing depressive symptoms and Zung Anxiety Scale rating anxiety manifestations, were adopted. Patients were divided into two groups based on the severity of mood disturbances according to BDI score. Effectiveness outcomes (monthly headache days (MHDs), monthly migraine days (MMDs), analgesic consumption, Numerical Rating Scale (NRS), Migraine Disability Assessment (MIDAS) score, Headache Impact Test (HIT-6) score) and self-assessment anxiety and depression scales (BDI, Zung) were analysed after 3 and 6 months of treatment.

Results: Effectiveness outcomes showed a significant clinical improvement at T3 (ΔMHD - 9.99 ± 7.82 in Group 1, -10.82 ± 7.62 in Group 2) and T6 (MHD - 10.30 ± 7.41 in Group 1, -10.61 ± 7.87 in Group 2), irrespective of the presence of associated mood symptoms. Treatment resulted in a notable improvement in anxiety and depressive manifestations, with significant reduction in BDI and Zung scales at T3 (ΔBDI - 1.30 ± 3.74 in Group 1, -6.35 ± 11.34 in Group 2) and T6 (ΔBDI - 1.67 ± 4.77 in Group 1, -8.06 ± 10.35 in Group 2).

Conclusions: This study corroborates the effectiveness of anti-CGRP antibody treatment in migraine patients, irrespective of the presence of comorbid mood-related symptoms. Furthermore, the persistently favourable outcome in mood symptom severity and intensity throughout the course of treatment substantiates the beneficial impact of this therapeutic approach.