Effect of Galcanezumab on PHQ-9 and GAD-7 in Patients with Migraine: A Real-world Study in Japan.

Objective Patients with migraine are at increased risk of developing psychiatric comorbidities, particularly depression and anxiety. Recently, anti-calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) have been suggested to be effective not only for migraine but also for comorbid depression. However, their effectiveness in depression and anxiety remains inconclusive, particularly in Asian populations. This study evaluated the effect of galcanezumab on depressive and anxiety symptoms in patients with migraine. Methods We conducted a single-center, retrospective, real-world study of 27 Japanese patients with migraine who received galcanezumab at Keio University Hospital, using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scores at two time points (baseline and 3-5 months after initiating galcanezumab) to evaluate depressive and anxiety symptoms. Results During galcanezumab treatment, the mean monthly migraine days (MMD) significantly decreased from 13.6±8.2 to 8.5±9.3 (p<0.001). PHQ-9 scores significantly decreased from 5.8±4.4 to 4.5±4.2 (p=0.010) and GAD-7 scores from 4.0±3.9 to 3.1±3.5 (p=0.030). No significant correlation was observed between changes in PHQ-9/GAD-7 scores and changes in MMD, numerical rating scale scores, or associated symptoms. Furthermore, Fisher's exact tests showed no significant association between improvements in PHQ-9/GAD-7 scores and MMD reduction. Conclusion Galcanezumab improved PHQ-9 and GAD-7 scores in Japanese patients with migraine. These improvements may be partly attributable to the direct effects of galcanezumab, independent of its effect on migraine frequency.