Long‐term Study of Propranolol in the Treatment of Migraine

Diamond, Seymour; Kudrow, Lee; Stevens, John; Shapiro, David

doi:10.1111/j.1526-4610.1982.hed2206268.x

Cited by 79 publications

(41 citation statements)

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“…Propranolol and flunarizine have proven to be useful tools in migraine prophylaxis 3,7,1213 . This trial aims the comparison of the efficacy of propranolol to flunarizine and to propranolol plus flunarizine in migraine prophylaxis.…”

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confidence: 99%

Propranolol vs flunarizine vs flunarizine plus propranolol in migraine without aura prophylaxis. a double-blind trial

Bordini

Arruda

Ciciarelli

et al. 1997

Arq. Neuro-Psiquiatr.

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-Fourty-five migraine without aura patients underwent a parallel double-blind trial aiming the comparison of the effects of propranolol 60 mg/day to flunarizine 10 mg/day and to propranolol 60 mg/day plus flunarizine 10 mg/day simultaneously. There were 3 groups, each one with 15 patients. After a 20-day-baseline period, each group received one kind of treatment during 120 days. Migraine index on propranolol was 23.4*. on flunarizine 18.7* and on both drugs 14.4*, mean frequency of attacks on propranolol was 1.26**, on flunarizine 1.2** and on both drugs 1.13** (*p<0.05, ** p < 0.01 compared to baseline) and global evaluation was reduced with all forms of treatment. It was not found statistical differences between groups, nevertheless there was a trend in the group using two drugs reaching lower values in migraine index, frequency of attacks and global evaluation. In individuals using flunarizine (alone or associated with propranolol) the therapeutic effect was largely maintained up to 45 days after drug withdrawal.KEY WORDS: migraine trial, propranolol and migraine, flunarizine and migraine, migraine and polytheraphy.Ensaio duplo-cego comparando propranolol, flunarizina e flunarizina associada ao propranolol na profilaxia da migrânea sem aura RESUMO -Quarenta e cinco pacientes com migrânea sem aura submeteram-se a ensaio paralelo e duplo-cego visando comparar os efeitos de propranolol (PPN), flunarizina (FNZ) e uso associado de propranolol mais flunarizina. Foram divididos em três grupos de 15 indivíduos. Após período preliminar de 20 dias sem a administração de qualquer droga, um grupo recebeu PPN 60 mg/dia, outro grupo FNZ 10 mg/dia, e o terceiro grupo PPN 60 mg/dia associado à FNZ 10 mg/dia. O tempo de tratamento foi 120 dias. O índice de dor no grupo sob PPN passou de 39,3 para 23,4 (p<0,05) no grupo sob FNZ de 33,7 para 18,7 (p<0,05) e no grupo recebendo ambas as drogas de 33,5 para 14,4 (p<0,05). Não houve diferenças entre os índices de dor dos três grupos após o tratamento. A frequência de crises no grupo sob PPN passou de 2,8 para 1,26 (p<0,01) no grupo sob FNZ de 2,6 para 1,2 (p<0,01) e no grupo recebendo ambas as drogas de 2,9 para 1,13 (p<0,01). Não houve diferenças entre as frequências de crises dos três grupos após o tratamento. Foram confirmadas as eficácias dessas drogas na profilaxia da migrânea sem aura. A associação das drogas não logrou benefício ulterior no que concerne à diminuição dos índices de dor ou da frequência de crises. Entretanto, na avaliação global por parte do paciente, os melhores resultados estavam entre os que usaram duas drogas. Nos grupos que usaram FNZ (isolada ou associada ao PPN), as melhoras alcançadas persistiram mesmo após 45 dias da retirada dos fármacos.PALAVRAS CHAVE: migrânea, propranolol na migrânea, flunarizina na migrânea, migrânea e politerapia.

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confidence: 99%

Propranolol vs flunarizine vs flunarizine plus propranolol in migraine without aura prophylaxis. a double-blind trial

Bordini

Arruda

Ciciarelli

et al. 1997

Arq. Neuro-Psiquiatr.

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“…Long-term trials also confirmed the efficacy of propranolol [Diamond et al, 1982]. Despite positive reports from various clinical trials on the use of other b-blockers in migraine prophylaxis, only propranolol and timolol have received approval from the FDA for the indication of migraine prevention.…”

Section: B-blockersmentioning

confidence: 83%

Evolution of migraine drugs

Diamond

2007

Drug Development Research

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Headache is an ancient malady that has affected every age and country. As such, the quest for relief has been recorded for more than 6,000 years. In modern times, new remedies as well as those based in ancient herbal remedies have been investigated and initiated into the regimen of headache therapies. During the past five decades, several breakthroughs, such as the approval of propranolol for the indication of migraine prophylaxis, have empowered headache research. The introduction of the triptans during the 1990 s spearheaded a resurgence of interest in headache by researchers and clinicians, and the pharmaceutical industry. It is hoped that this renewed quest for headache relief will flourish, benefiting the millions of sufferers throughout the world. Drug Dev Res 68: 270-275, 2007.

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“…Propranolol hydrochloride is used routinely in adults at doses of 240-320mg/day for indications such as migraine prophylaxis 15,16 and essential tremor 17-19 and has been used safely in burn patients to decrease the metabolic consequences of burn injury. 20-22 Based on this safety profile and lack of established dose regimen for burn pain, a dose of 120mg BID of propranolol (240mg/day) was selected for patients receiving active study drug.…”

Section: Methodsmentioning

confidence: 99%

Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury

Orrey

Halawa

Bortsov

et al. 2015

The Clinical Journal of Pain

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Background Results of previous studies suggest that β-adrenoreceptor activation may augment pain, and that β-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high activity haplotype. Methods Consenting patients admitted for thermal burn injury at participating burn centers were genotyped; those who were not high activity COMT homozygotes were randomized to propranolol 240mg/day or placebo. Primary outcomes were study feasibility (consent rate, protocol completion rate) and pain scores on study days 5-19. Secondary outcomes assessed pain and posttraumatic stress disorder (PTSD) symptoms 6 weeks post-injury. Results Seventy-seven (61/79) percent of eligible patients were consented and genotyped, and 77% (47/61) were genotype-eligible and randomized. Ninety-one percent (43/47) tolerated study drug and completed primary outcome assessments. In intention to treat and per protocol analyses, patients randomized to propranolol had worse pain scores on study days 5-19. Conclusions Genotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury.

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Long‐term Study of Propranolol in the Treatment of Migraine

Cited by 79 publications

References 4 publications

Propranolol vs flunarizine vs flunarizine plus propranolol in migraine without aura prophylaxis. a double-blind trial

Propranolol vs flunarizine vs flunarizine plus propranolol in migraine without aura prophylaxis. a double-blind trial

Evolution of migraine drugs

Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury

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