The following article is a part of conference coverage from the American Psychiatric Association Annual Meeting 2021, held virtually from May 1 to 3, 2021. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the APA 2021.


Fremanezumab treatment for migraine is associated with clinically meaningful reductions in monthly migraine days and with improved symptoms of associated major depressive disorder (MDD) and generalized anxiety disorder (GAD), according to study results presented at the American Psychiatric Association annual meeting, held virtually from May 1 to May 3, 2021.

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MDD and GAD are common psychiatric comorbidities associated with migraine. According to the researchers, the odds of experiencing either depression or anxiety are more than 3 times higher for people with migraine, compared with those without migraine.

To assess the real-world effectiveness of fremanezumab in patients with migraine and MDD or GAD within the 6 months following treatment initiation, researchers conducted a retrospective, online, panel-based physician chart review. Adults with chronic or episodic migraine who had received ≥1 dose of fremanezumab and had a baseline monthly migraine day measurement were included in the study. Changes in both monthly migraine days and physician-assessed severity of MDD or GAD were evaluated in subgroups.

The total cohort included 421 physicians and 1003 patients (MDD n=134; GAD n=120). Among patients with MDD or GAD, mean monthly migraine days measurements were 14.5 and 14.3, respectively. Mean reductions from baseline in monthly migraine days at 1 month were -5.4 and -5.7 (37.2% and 39.9%) in MDD and GAD, respectively. Reductions at 3 months were -6.8 (46.9%) and -7.2 (50.3%), and -9.9 (68.3%) and -9.5 (66.4%) at 6 months.

The severity of MDD and GAD symptoms at baseline were reported by physicians as mild in 37.3% and 35.8% of patients, respectively, moderate for 45.5% and 45.8%, and severe for 10.4% and 15.8%. Physicians reported that MDD and GAD symptom severity improved in 45.5% and 45.8% of patients, respectively, while 1.5% and 0.8% of patients experienced worsened symptoms and 47.8% and 50.8% experienced no change.

“In this US real-world study, fremanezumab treatment was associated with clinically meaningful reductions in MMD [monthly migraine days] that increased over 6 months for patients with MDD or GAD at baseline,” the study researchers concluded. “Almost half of all patients with these psychiatric comorbidities showed improved symptoms of MDD and GAD with fremanezumab treatment.”

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Cohen JM, Thompson S, Patterson-Lomba O, et al. Fremanezumab treatment reduced monthly migraine days and anxiety or depression symptoms for migraine patients with comorbid MDD or GAD in this US Real-World Study. Presented at: APA annual meeting May 1-3, 2021. Abstract/Poster 5443