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Beta Blockers

Beta blockers are sometimes used to prevent migraine. They were originally developed to treat high blood pressure and other heart symptoms. But they also reduce the frequency of migraine attacks in 60 to 80 percent of people.1 This fact was discovered by coincidence in the 1960s.2

Beta blockers have not been prescribed to stop migraine attacks that are already in progress, although there is recent preliminary evidence that beta blockers in eye drops might disrupt an active migraine.2

Still, many people who experience severe migraine need two kinds of medication—one for acute episodes and another for prevention.

How do beta blockers work?

Beta blockers work to relax and open up blood flow in blood vessels. Changes in blood vessels in the brain are thought to cause migraine, however it is unclear exactly how beta-blockers prevent migraine symptoms.

In general these medicines work by blocking chemicals called neurotransmitters in the body from interacting with beta receptors, which sit within blood vessels and other tissues. Beta-blockers are sometimes called beta-adrenergic blocking agents. They block the effect of adrenaline, the body’s natural fight or flight chemical. They also reduce blood pressure and slow the heartbeat.

What are some common beta blockers for migraine?

  • Propranolol (Inderal® XL, InnoPran® XL)
  • Timolol
  • Metoprolol (Lopressor®)
  • Atenolol (Tenormin®)
  • Nadolol (Corgard®)
  • Bisoprolol (Zebeta®)
  • Carvedilol (Coreg®)3,4

What are some side effects of beta blockers?

  • Fatigue
  • Nausea or diarrhea
  • Dizziness
  • Reduced ability to exercise
  • Insomnia, sleep problems, nightmares and vivid dreams
  • Memory problems
  • Depression
  • Weight Gain
  • Exacerbation of asthma

This is not a complete list of side effects.

What else should I know about beta blockers for migraine?

Preventive medications for migraine should be taken daily, and it’s generally advisable to take them for six to eight weeks before assessing how well they work. It’s also important to taper off these medications when stopping their use and never stop them suddenly.

People with asthma, emphysema, moderate to severe chronic obstructive pulmonary disease (COPD), diabetes, sinus bradycardia (a slow pulse), partial AV block heart block, and low blood pressure should use beta blockers with caution. Those with the circulatory problem, peripheral artery disease are sometimes advised against taking beta blockers.

Earlier studies of beta blockers taken during pregnancy showed they might slightly slow fetal growth or cause congenital heart defects, but more recent research that adjusts for characteristics of the mother show that some beta blockers are safe during pregnancy.5 Women are pregnant should consult with their healthcare providers before taking beta blockers.

It is always important to talk to your doctor about all the medications you are taking, because some do not mix well with beta blockers.

Written by: Sara Finkelstein | Last reviewed: August 2019
  1. Zahid Bajwa, R Joshua Wootton. Patient education: Migraine headaches in adults (Beyond the Basics). Published July 11, 2017. Up To Date. Accessed April 29, 2018.
  2. Ryan Cady, J. Kent Dexter, Roger Cady. Use of Beta-Blocker Ophthalmic Solution for the Treatment of Migraine. Headache News. July 1, 2014. National Headache Foundation. Accessed April 29, 2018.
  3. Headache Medications. The Cleveland Clinic. July 8, 2014. Accessed April 29, 2018.
  4. Preventive Treatments. American Migraine Foundation. November 28, 2016. Accessed April 29, 2018.