[Beta-blockers and migraine].
Five beta-blocking agents are effective as long-term prophylactic treatment of migraine: propranolol, metoprolol, timolol, atenolol and nadolol. Propranolol has been most extensively studied and proved effective in 19 of 21 controlled trials. The optimal dose should be determined on a case-by-case basis, by increasing the daily dosage gradually. Among the properties of beta-blockers, the only one which appears to be correlated--albeit negatively--with effectiveness on migraine is intrinsic sympathomimetic activity (ISA): drugs without ISA are effective against migraine whereas partial agonists are not. The mode of action of beta-blockers in migraine is still poorly understood; one of the most cogent current hypotheses involves reduction of brain catecholaminergic hyperactivity.
Service de Neurologie, Hôpital Saint-Antoine, Paris, France.
H
H
Massiou
M G
MG
Bousser
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D001262:Atenolol / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004108:Dilatation, Pathologic / Q000188:drug therapy; D005074:Evoked Potentials, Visual / Q000187:drug effects; D006801:Humans; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000188:drug therapy*; D009248:Nadolol / Q000494:pharmacology / Q000627:therapeutic use; D010974:Platelet Aggregation / Q000187:drug effects; D011433:Propranolol / Q000494:pharmacology / Q000627:therapeutic use*; D011985:Receptors, Serotonin / Q000187:drug effects; D013999:Timolol / Q000494:pharmacology / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D011985:Receptors, Serotonin; D009248:Nadolol; D001262:Atenolol; D013999:Timolol; D011433:Propranolol; D008790:Metoprolol
Bêta-bloquants et migraine.