How are beta blockers used in treatment of migraine?
Several studies have found that chronic therapy with propranolol reduces the frequency and severity of migraine in 60 to 80 % of patients. Although only propranolol and timolol have been approved by the FDA for this indication, metoprolol, nadolol, and atenolol are commonly used. It can take several weeks for these drugs to become effective; the dose should be titrated and maintained for at least three months before deeming the medication a failure. The mechanism of the effectiveness in migraine prophylaxis (but not to terminate an acute attack) seems to be related to inhibition of central neurotransmitter release (norepinephrine and serotonin) which trigger the attack.
