Alpha 1-adrenergic blockers: do they have a place in the prophylaxis of migraine?

On the basis of the author's personal experience with migraine, and occasional reports in the literature suggesting that alpha 1-adrenergic blocking drugs may have a beneficial effect in the prophylaxis of migraine, 10 patients with migraine in a general neurology practice were placed on either terazosin or doxazosin. A decrease in migraine frequency or severity or both was seen in all but 1 patient, but 5 patients discontinued the drug due to side effects. No serious adverse reactions were reported. This anecdotal experience with the alpha 1-adrenergic blockers warrants a controlled, double-blind study of this class of drugs for the prophylaxis of migraine.