Propranolol for migraine prophylaxis

Linde, Klaus; Rossnagel, Karin

doi:10.1002/14651858.cd003225.pub3

Cited by 8 publications

(6 citation statements)

References 81 publications

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“…Also, beta-blockers may reduce the recurrence of SCAD events 23 but also are utilized as migraine prophylaxis. 24 Thus, beta-blockers may be particularly useful in patients with SCAD for their potential to treat angina, reduce SCAD recurrence, and prevent migraine headaches.…”

Section: Discussionmentioning

confidence: 99%

Migraine headache in patients with spontaneous coronary artery dissection: A report of the iSCAD Registry

Wells,

Wood,

O’Duffy

et al. 2024

Vasc Med

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Introduction: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified. Methods: Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine. Results: Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were more likely to be women (96.9% vs 90.3%, p = 0.0003). The presence of underlying carotid fibromuscular dysplasia was associated with migraine (35% vs 27%, p = 0.0175). There was not a significant association with carotid artery dissection and migraine. Current migraine frequency was less than monthly (58%), monthly (24%), weekly (16%), and daily (3%). Triptan use was reported in 32.5% of patients, and 17.5% used daily migraine prophylactic medications. Using the MIDAS to quantify disability related to migraine, 60.2% reported little or no disability, 14.4% mild, 12.7% moderate, and 12.7% severe. The mean MIDAS score was 9.9 (mild to moderate disability). Patients with SCAD had higher rates of depression and anxiety (28.2% vs 17.7% [ p = 0.0004] and 35.3% vs 26.7% [ p = 0.0099], respectively). Conclusions: Migraines are common, frequent, and a source of disability in patients with SCAD. The association between female sex, anxiety, and depression may provide some insight for potential treatment modalities.

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Section: Discussionmentioning

confidence: 99%

Migraine headache in patients with spontaneous coronary artery dissection: A report of the iSCAD Registry

Wells,

Wood,

O’Duffy

et al. 2024

Vasc Med

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“…Tacrine, a reversible cholinesterase inhibitor [ 55 ], is a major substrate of CYP1A2 and CYP3A4 [ 56 ]. Propanolol is commonly prescribed for migraine prophylaxis and anxiety treatment [ 57 , 58 ]. Our findings suggest that Group B, in which patients did not show an improvement in 5mC levels during follow-up, contained a lower frequency of subjects that were normal metabolizers (40%, compared to 75% in Group A) and a higher frequency of patients that were ultra-rapid metabolizers.…”

Section: Discussionmentioning

confidence: 99%

Influence of Metabolic, Transporter, and Pathogenic Genes on Pharmacogenetics and DNA Methylation in Neurological Disorders

Martínez-Iglesias,

Naidoo,

Carrera

et al. 2023

Biology

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Pharmacogenetics and DNA methylation influence therapeutic outcomes and provide insights into potential therapeutic targets for brain-related disorders. To understand the effect of genetic polymorphisms on drug response and disease risk, we analyzed the relationship between global DNA methylation, drug-metabolizing enzymes, transport genes, and pathogenic gene phenotypes in serum samples from two groups of patients: Group A, which showed increased 5-methylcytosine (5mC) levels during clinical follow-up, and Group B, which exhibited no discernible change in 5mC levels. We identified specific SNPs in several metabolizing genes, including CYP1A2, CYP2C9, CYP4F2, GSTP1, and NAT2, that were associated with differential drug responses. Specific SNPs in CYP had a significant impact on enzyme activity, leading to changes in phenotypic distribution between the two patient groups. Group B, which contained a lower frequency of normal metabolizers and a higher frequency of ultra-rapid metabolizers compared to patients in Group A, did not show an improvement in 5mC levels during follow-up. Furthermore, there were significant differences in phenotype distribution between patient Groups A and B for several SNPs associated with transporter genes (ABCB1, ABCC2, SLC2A9, SLC39A8, and SLCO1B1) and pathogenic genes (APOE, NBEA, and PTGS2). These findings appear to suggest that the interplay between pharmacogenomics and DNA methylation has important implications for improving treatment outcomes in patients with brain-related disorders.

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“…Recognition of the association of migraine and POTS has significance for patient management. Migraine preventative treatment may be chosen to treat both conditions, such as with beta-blockade, and lifestyle advice may need to be tailored in consideration of the co-morbidity (58,59). Further prospective study is required however to determine the optimal treatment of these comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of headache disorders in Postural Tachycardia Syndrome: A systematic review and meta-analysis of the literature

et al. 2022

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Background Headache is a common presentation of postural tachycardia syndrome, yet robust prevalence data is lacking. Objectives To undertake a systematic review and meta-analysis to estimate the prevalence of headache disorders in postural tachycardia syndrome, and to explore the potential shared pathophysiological mechanisms that underpin these conditions as well as treatment options. Methods Three databases were searched for publications evaluating prevalence of migraine (primary outcome) and general and orthostatic headache (secondary outcomes) in patients with postural tachycardia syndrome. Two independent reviewers selected studies and extracted data. A random-effects meta-analysis calculated the pooled prevalence of migraine in postural tachycardia syndrome. A narrative literature review explored the pathophysiology and treatment options for concurrent headache disorders and postural tachycardia syndrome. Results Twenty-three articles met inclusion criteria. Estimated pooled prevalence of migraine in postural tachycardia syndrome was 36.8% (95% CI 2.9–70.7%). Various shared pathophysiological pathways for these conditions, as well as proposed treatment strategies, were identified. Limitations: Heterogeneity of study design, populations, and methodology for identifying headache disorders and postural tachycardia syndrome limited the generalisability of results. Conclusions Migraine is a commonly reported comorbidity in POTS, however the true prevalence cannot be determined from the current literature. Further studies are required to assess this comorbidity and investigate the underlying mechanisms, as well as identify effective treatment strategies.

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Propranolol for migraine prophylaxis

Abstract: The editorial group responsible for this previously published document have withdrawn it from publication.

Cited by 8 publications

References 81 publications

Migraine headache in patients with spontaneous coronary artery dissection: A report of the iSCAD Registry

Migraine headache in patients with spontaneous coronary artery dissection: A report of the iSCAD Registry

Influence of Metabolic, Transporter, and Pathogenic Genes on Pharmacogenetics and DNA Methylation in Neurological Disorders

The prevalence of headache disorders in Postural Tachycardia Syndrome: A systematic review and meta-analysis of the literature

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