Beta Blockers

Beta-blockers, which are normally used to treat hypertension (chronic high blood pressure), may also be prescribed to prevent migraine attacks.

Beta-blockers are taken on an everyday basis to reduce blood pressure, and they are also used daily when recommended for migraine prevention.

Beta-blockers relax blood vessels throughout the body, which is why they are used for the management of hypertension. They are usually a daily pill, but you may be asked to take them morning and night.

Beta-blockers have several actions that may help in reducing migraine attacks:

• reduce brain blood flow by directly acting on the blood vessels in the brain;
• induce a change in the electrical activity of the brain, preventing an effect described as cortical spreading depression—a type of slow brain activity associated with the early stages of migraine attack and migraine aura;
• increase activity in the hypothalamus, a region of the brain that has been associated with migraine.

It isn’t completely clear which of these effects occurs first or which has the most powerful impact on reducing migraine attacks. As with all treatments, beta-blockers will not work for everyone, but there is some evidence they can be helpful, particularly if your migraine attacks are triggered by physical activity or exercise.

If you are already taking a beta-blocker for hypertension, this does not automatically mean that it will prevent your migraines.

Inderal (propranolol) is the beta-blocker that has been used and studied the most when it comes to migraine prevention, and there is a good body of evidence that it can have benefit for people living with migraine.

As with all medications, there are side effects, and you should discuss your options carefully with your GP or neurologist.

Read more about the effectiveness of beta-blockers for migraine at AJMC.