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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
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Low-Dose Propranolol versus Amitriptyline for Episodic Migraine Prophylaxis: A Randomized Controlled Trial Assessing
Vandana Roy1, Nasra Banu2, Girish Gulab Meshram2
1Department of Pharmacology, Maulana Azad Medical College and Associated Hospitals, New Delhi, 110002, India. roy.vandana@gmail.com.
Clinical Drug Investigation
|September 11, 2025
Summary
Low-dose propranolol is more effective than amitriptyline for preventing episodic migraines, reducing headache frequency and days. However, amitriptyline is more cost-effective, despite both medications being well-tolerated with mild side effects.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Limited head-to-head data exists for propranolol and amitriptyline in migraine prophylaxis.
- Episodic migraine significantly impacts quality of life and healthcare costs.
Purpose of the Study:
- To compare the efficacy, safety, and cost-effectiveness of low-dose propranolol versus amitriptyline for episodic migraine prophylaxis.
- To evaluate treatment outcomes over a 3-month period.
Main Methods:
- A randomized, controlled, open-label, prospective trial involving 60 prophylaxis-naïve episodic migraine patients.
- Patients received either low-dose propranolol (80 mg/day) or amitriptyline (10 mg/day).
- Primary outcome: reduction in monthly headache frequency; secondary outcomes: ≥50% headache reduction, severity, disability, rescue medication use, quality of life, and cost-effectiveness.
Main Results:
- Propranolol significantly reduced monthly headache frequency more than amitriptyline (-3.67 vs -2.87 days, P=0.03).
- A higher proportion of patients on propranolol achieved ≥50% reduction in headache days (60% vs 43.33%, P=0.02).
- Propranolol led to greater reduction in rescue medication use (P=0.01), but cost-effectiveness favored amitriptyline.
Conclusions:
- Low-dose propranolol demonstrates superior efficacy compared to amitriptyline for episodic migraine prophylaxis.
- Both medications were well-tolerated with mild adverse drug reactions.
- Amitriptyline was found to be more cost-effective than propranolol in this trial.
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