Atenolol in the prophylaxis of chronic migraine: a 3-month open-label study

Chronic migraine (CM) is a type of chronic daily headache. CM presents a challenge to primary care physicians and neurologists. Any new treatment showing efficiency would therefore be of great importance. Atenolol together with other beta-blockers is a first-line choice in episodic migraine prophylaxis. Clinical findings support the efficacy of atenolol in doses of 50 to 200 mg/day.

Here I present an open-label study the aim of which is to evaluate the efficacy and tolerability of atenolol (50 mg o.d) for the prevention of CM. 19 patients affected by CM were studied.

Following a one-month run-in period, the patients took atenolol for 3 months. Mean numbers of headache days per month were reduced from 20.1 ± 2.4 during the run-in period to 7.8 ± 6.1 by month 1.5 and to 7.1 ± 5.7 by the 3rd month of treatment (p < 0.0003). There was a significant difference between 1.5 months and the 3rd month (p < 0.006). The severity of attacks was reduced from a mean 2.3 ± 0.6 to 1.4 ± 1.1 (p < 0.010) at 1.5 months. In this, there was no difference between 1.5 months and the 3rd month. In 5 (29%) of the17 patients who completed the study, CM was totally gone during the 3rd month of treatment. No patient was totally unresponsive to the drug. Among the patients who completed the study, the treatment was well tolerated and the compliance was good.

Atenolol seems to be a safe and effective treatment for CM. Controlled trials are needed to confirm the observed results.