Candesartan: Effective Preventive, Low Weight Gain Risk
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For migraine prevention, candesartan (Atacand),  is as effective as the frequently prescribed beta blocker propranolol (Inderal), a recent study found.1 Plus candesartan is less likely to cause weight gain than other migraine preventives2 and is available as a generic.

In the study, each patient had three separate treatment periods. They took one drug for 12 weeks, then stopped it and took nothing for four weeks. They did the same with the other drug and also with a placebo. Neither the patients nor the doctors knew whether a patient was taking candesartan, propranolol or a placebo during any given time period.

The response rate to candesartan and propranolol were significantly higher than to the placebo. When participants were taking candesartan, 43% reported relief. With propranolol, 40% had relief. The placebo response rate was 23% (which is pretty typical in migraine studies).

Unsurprisingly, more side effects were reported on candesartan and propranolol than on the placebo. The associated side effects were somewhat different between the two drugs. For candesartan, the most frequent side effect was dizziness, for propranolol, it was body pain.

Candesartan could be effective for those who have tried propranolol without success or can’t take beta blockers because of another medical issue. (Both drugs were developed to treat high blood pressure but they work in different ways. Candesartan has fewer contraindications than beta blockers, so more people can potentially take it.)

All in all, candesartan seems like a good drug to ask your doctor about. And, if you don’t have a contraindication or haven’t tried it already, propranolol is also worth looking into. Be sure to tell your doctor if you have a propensity toward the side effects of either drug. This could help them decide which is treatment is a better choice for you or give you recommendations for coping with the side effects.

My headache specialist is excited about candesartan and I have a prescription waiting. I’ll let you know how it works out for me.

view references
  1. Stovner LJ, Linde M, Gravdahl GB, Tronvik E, Aamodt AH, Sand T, Hagen K. A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomised, triple-blind, placebo-controlled, double cross-over study. Cephalalgia. 2013 Dec 11.
  2. Diener HC. Medscape Neurology: An Option in Migraine Prevention? http://www.medscape.com/viewarticle/821200
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