Migraines: antihypertensive agents help

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MunichPulsating headache, visual disturbances and nausea - an estimated eight million people in Germany suffer from migraines. The severe symptoms are usually treated with drugs such as high-dose analgesics or triptans. But a completely different drug also seems to prevent migraines and alleviate the symptoms: antihypertensive drugs.

A chance find

Anti-hypertensive drugs containing the active ingredient candesartan have long been prescribed for the treatment of essential hypertension. A former professor at St. Olav's Clinic in Trondheim (Norway) was treated with candesartan 20 years ago for high blood pressure. Surprisingly, this apparently not only kept the professor's blood pressure in check, but also relieved his severe headache - that's what records the man said said. These observations prompted researchers to take a closer look at the effects of this active ingredient.

Three preparations in comparison

A research team recruited 72 migraine patients for the studies, who suffered from migraine attacks at least twice a month. Over a period of one year, they successively test three different anti-migraine preparations for their effectiveness. To do this, they were given either a drug with the active ingredient candesartan, a beta blocker called propranolol, which is also used to treat migraines, or a placebo for twelve weeks. The participants did not know which preparation they were taking. There was a four week break between taking the various drugs. This should show how the previous medication affected the headache attacks.

Attacks reduced by a quarter

The results confirmed the observations that the professor emeritus made many years ago: The migraine attacks were reduced by around a quarter when the participants took the antihypertensive drug. It became clear that the high blood pressure drug candesartan prevents the symptoms just as well as the beta blocker propranolol. But even the placebos relieved symptoms by around 20 percent. This is also confirmed by a recent study by the Harvard Medical School: the mere fact of swallowing a pill at all helps against the pain.

More treatment options

"The antihypertensive drug relieves headaches and gives doctors the opportunity to help more people with migraines," explains Professor Lars Jakob Stovner. For patients who are not helped by treatment with propranolol, for example, alternative therapy with candesartan may prove effective. (jb)

Sources:

Stovner, L. et al. A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomized, triple-blind, placebo-controlled, double cross-over study. SAGE journals.

Rami Burstein *: Altered Placebo and Drug Labeling Changes the Outcome of Episodic Migraine Attacks; 8 January 2014, Sci. Transl. Med. 6, 218ra5

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