Candesartan: Effective Preventive, Low Weight Gain Risk

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?
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8 comments on “Candesartan: Effective Preventive, Low Weight Gain Risk

  1. gt1990 says:

    How did this one work out for you? I couldn’t find a followup post. Thanks.

  2. Kerrie Smyres moderator author says:

    Hi gt1990, I was only on it a couple weeks. It lowered my blood pressure too much and caused major fatigue. My blood pressure tends to be on the low side, so it wasn’t a good choice for me.

    Take care,

  3. Stefania says:

    I was just put on candesartan. I started out with 8mg but it made me so sleepy, I passed out. So now I am trying 4 mg to let my body adjust and then increase from there.

    I also had Botox in March and it is time for my second one.

    I was in triptan rebound this weekend and stayed home to deal with the pain, take lots of OTC (which I will then have to withdrawal from).

    I have worked as a psych RN and can’t believe I have tried all the meds my patients get but for migraines.

    Tired of pills

  4. Stefania says:

    I have chronic migraines and had my first round of Botox in March. Didn’t work and I will try the second.

    In the meantime, my neuro put me on candesartan 8mg. It has made me incredibly dozy and I was found on the floor once. I am not usually a wimp with meds. SO, I refuse to give up and am starting on 4mg a day, then work up…

  5. Sofie'smom says:

    I’ve been taking candesartan for about eight or nine months. I’ve gone from about 10-11 migraines a month to about five. Sometimes I can go a week, sometimes three days in a row, depending on the triggers. My problem is that for most other meds, the side effects outweigh the possible good effects, and I’m pretty much stuck at this point unless and until something new comes on the market. I carry around sumatriptan so I can take it as soon as the pain starts.

  6. Approximately 20 years ago I took a preventative medicine for the severe chronic migraines which I began to develop during my teens, quickly escalated & diagnosed at age 23 when I had my first full-fledged, all-out, all-bad symptoms included, and became chronic in my mid-late thirties (I am now 56 & post menoafter age 23,pausal). Although I am not positive (& the Drs notes, unbelievably, do not confirm any med. chgs; they’re sketchy at best!) I believe the med was Inderal. I had a full year relatively free from migraine, which was wonderful, except it then abruptly stoppered working – just like that1. N21o 2dosage adjustments, etc would get it back on track.
    I have taken virtually every line of preventative medications, from anti-depressants (incl. MAOI’s) to Beta Blockers to Anti-seizure meds, & in every dose.

  7. Ah! I must have reached my word limit or pressed post by mistake! I also see I made it look like I went thru menopause at age 23, which is not true; I was 50.
    ANYWAY… The reason I was sharing all this info was in an attempt to see if anyone had the same experience with Inderol working for their migraines and then suddenly stopped working? or this one called candesartan. Has anyone else tried it again with success? Does candesartan work for some when Inderol does not? Thanks for any info anyone may have! K

  8. Kerrie Smyres moderator author says:

    That some drugs can be effective for a person then stop working is a great mystery of headache medicine. This happens with a variety of different drugs and no one really knows why. Since so much time has passed since you used it, it might be worth trying Inderal again. Candesartan could be a possibility, too. It can work for some when propanolol doesn’t and vice versa, but some people find both to be effective.

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