In the interest of brain health, are you avoiding TCAs in migraine treatment due to increased dementia risk?

One more reason to abandon the old-fashioned non-specific preventive migraine medications: anticonvulsants, tricyclics, and calcium antagonists. The only class of old-fashioned medications that I still use, be it rarely, is that of the beta-blockers, with the exception of propranolol. There is good ...

I try to avoid them in patients over 65, but I will occasionally use a low dose of nortriptyline, up to 25 mg, if the patient also struggles with sleep, neuropathic pain, or IBS-D.