Depressive and anxiety symptoms during CGRP-targeted migraine prevention: A systematic review and meta-analysis
Abstract
Background Migraine is frequently comorbid with depression and anxiety, conditions that amplify disease burden and may impair preventive treatment response. Calcitonin gene-related peptide (CGRP)-targeted therapies have demonstrated robust efficacy in reducing migraine frequency, with emerging evidence suggesting concurrent improvements in psychiatric symptom burden. However, findings derive from heterogeneous study designs and outcome instruments, limiting conclusions regarding consistency and magnitude of these effects. Methods We conducted a systematic review and meta-analysis of studies reporting changes in depressive and anxiety symptoms in adults with migraine receiving CGRP-targeted preventive therapies. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO were searched from inception through July 2026. Eligible studies included randomised controlled trials, post hoc analyses, and real-world observational studies reporting validated self-report or clinician-rated symptom measures at baseline and follow-up. Risk of bias was assessed using the Jadad Scale for randomised trials and the Newcastle-Ottawa Scale for observational studies. Standardised mean differences with 95% confidence intervals were calculated using random-effects models. Results Twelve studies (n = 3603; 63% female) published between 2020 and 2026 met eligibility criteria, of which nine contributed to quantitative synthesis. Pooled analyses demonstrated consistent…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,603 participants or records.
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