The treatment of migraine with propranolol

Within recent years a variety of agents have been employed for the symptomatic and prophylactic treatment of the migraine syndrome.The responses to two such agents, ergot derivatives and methysergide, have often been so striking as to have achieved the stature of diagnostic criteria.Despite this fact, a number of migraine sufferers remain without effective therapy because either they are not benefited by these drugs or they cannot risk or tolerate the side effects produced by them.Recently, Rabkin et aL,l Wykes,z and Bekes et a13 independently noted seemingly fortuitous headache improvement in three patients with migraine treated for cardiovascular disease with propranolol, a beta-adrenergic receptor blocker.These observations coupled with our experimental results of propranolol's effects on cerebral blood flow and metabolism* prompted a controlled study on the efficacy of this substance as a modifier of the migraine syndrome. MethodThe study group consisted of 25 patients, 13 of whom were women.The mean age was 40.6 years, with a range of 19 to 61 years.In every instance these patients were recognized therapeutic management problems, and all met the established criteria for diagnosis of migraine.5Six patients failed to complete the study for reasons unrelated to the trail drug per se, so that 19 patients comprised the final study group.Thirteen of these patients had headache with no focal neurological distur-* Both drugs were provided by Ayerst Laboratories.