Preventive Treatment of Episodic and Chronic Migraine

Open Label Study of Milnacipran in the Preventive Treatment of Episodic Migraine With and Without Aura and Chronic Migraine.

This is an open label pilot study to determine whether milnacipran can reduce headache frequency in episodic and chronic migraine sufferers.

Patients with episodic migraine with and/or without aura and chronic migraine will be treated with 100 or 200 mg of milnacipran for a total of 4 months including a one month titration phase and a 3 month maintenance phase. Baseline (pre-treatment) and end-of-maintenance phase headache frequencies will be recorded. There is no placebo treatment in this study. In addition to headache frequencies, other parameters being measured include safety and tolerability.

Inclusion Criteria:

• Migraine with or without aura or chronic migraine.
• Subject age 18 to 70.
• At least 2 migraine attacks per month.
• Willing ang able to give written informed consent.
• Willing and able to complete the entire course of the study and to comply with study instructions.
• Willing to taper and discontinue their current preventive medications.

Exclusion Criteria:

• Subject is pregnant, lactating or planning a pregnancy in the next year.
• Subject is female of child-bearing potential and not taking adequate forms of birth control.
• Significant medical or psychiatric disease or abnormal laboratory data that would preclude entry into this study.
• Previous failure of four or more adequate trials of preventive medication.
• Currently on any form of antidepressant for depression and not able to discontinue.
• Currently demonstrating medication overuse headache.
• Currently has uncontrolled narrow angle glaucoma.
• Currently taking monoamine oxidase inhibitors.
• Subject has a history of seizures.
• Participation in an investigational drug study within the last 30 days or 5 half-lives, whichever is longer.