Zoloft is recommended by many neurologists for MAV: even though it’s not a particularly effective migraine prophylaxis drug. There’s a theory that some of the MAV is due to assymetrical neurotransmittors going to the vestibular apparatus. Personally, I only tried zoloft for a couple of days: I felt weird on it. In retropect, I should have cut back the dose.
I recently spoke to a neurologist from NYC who treats a lot of MAV, and his two favorite drugs are zoloft and verapamil.
There is definitely a withdrawal syndrome from anti-depressants: all of them, TCA’s, SSRI’s, SNRI’s and vertigo is part of the syndrome. Paxil seems to be a big offender.
So, you can get dizzy with the SSRI’s and get dizzy when you stop them, yet they’re recommended, along with TCA’s–which increase serotonin and norepinephrine (like the SNRI’s–effexor, cymbalta, wellbutrin) for MAV.
In my opinion, prozac isn’t milder than lexapro, it’s just different–a longer half life, easier to come off of.
Kira