Beta-Blockers, a Spanner in the Works for Acute Management of Migraine?

Abstract

Many patients suffer with migraine and do not feel their therapeutic needs are met, particularly in acute treatment. Betablockers are inexpensive, well-tolerated medications licensed for prophylaxis of migraine but not for acute treatment of episodic migraine (EM). However, this is based on trials that are possibly too narrow. A known association exists between migraine and various psychological disorders. In particular, anxiety disorder is implicated as a trigger and a pain modulator affecting experience and reporting of migraine. This case report highlights the need for a larger randomizedcontrolled trial assessing the efficacy of beta-blockers for the acute treatment of migraines, and in particular reviewing their effect in those patients with an associated anxiety disorder.