Treatment of migraine with propranolol

Thirty patients suffering from intractable, repetitive migraine took part in a double-blind single-crossover trial to compare the effect of propranolol (at 120 mg per day) with that of placebo. During propranolol treatment the frequency of migraine attacks was reduced significantly, by more that 50% in 9 patients and by less that 50% in a further 9. In the remainder propranlol showed no advantage over placebo. It is concluded that, as propranolol has only few and mild side effects, it is a useful drug for preventing migraine attacks. As the pathogenesis of migraine is not completely understood, the mode of action of propranolol in preventing attacks cannot be fully explained. It has been possible, however, to relate some of the effects of beta-receptor antagonism to current knowledge of the condition.