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Can Heart Medications Prevent Migraines?

Medically reviewed by Ed Zimney, MD
Q: Can a cardioselective beta-blocker prevent migraines?

Yes. The entire class of medications, called beta-blockers, is used to prevent migraine headaches and has been proven effective. These are drugs originally developed to treat high blood pressure and are also used to treat anginaand prevent heart attacks. The difference between selective and nonselective beta-blockers has to do with which beta receptors the medication targets. Selective beta-blockers inhibit the beta-1 receptor, located in the heart and kidneys. Nonselective beta blockers inhibit both beta-1 and beta-2 receptors, located in the lungs, gastrointestinal tract, blood vessels and other places.

The decision to prescribe a nonselective beta-blocker, such as Inderal (propranolol) versus a selective one, such as Lopressor (metoprolol), is based on the patient’s complete medical and medication history. For example, nonselective beta-blockers should not be prescribed to anyone with a history of asthma, since they are much more likely to exacerbate asthma compared to the selective beta-blockers.

Last Updated: 05/05/2008 | Last Reviewed: 05/05/2008
Dr. Stuart Stark is the medical director of the Neurology and Headache Treatment Center in Alexandria, Virginia.
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