Ryan J . Cady , MS , J . Kent Dexter , MD , Roger K . Cady , MD The Headache Care Center , Springfield , MO
In the annals of migraine , one of the more fascinating stories is how , in 1966 , a physician named Robert Rabkin observed that the drug propranolol could prevent migraine . Dr . Rabkin was actually conducting a study using a beta-blocker ( propranolol ) to treat heart pain ( angina ) and fortuitously observed that one of his research subjects had a remarkable reduction in the frequency of his migraine attacks . A decade later , Drs . Seymour Diamond and John Graham presented their experience treating 86 migraine patients with daily propranolol to the Food and Drug Administration ( FDA ), and demonstrated that propranolol was indeed efficacious and safe for migraine prophylactic therapy . Subsequently , propranolol became the first FDA-approved medication for the prevention of migraine .
As one of many beta blockers used commonly to prevent migraine , propranolol currently , is probably the mostly widely prescribed medication in the world for prevention
of migraine . Beta blockers are used to treat multiple diseases including high blood pressure , heart pain , and irregularities of the heart as well as conditions such as anxiety and certain types of tremors . Beta blockers have been so successful that they are considered one of the most important medical discoveries of the 20 th century .
In 1978 , a second beta blocker , timolol , also received FDA approval as the first topical beta blocker for the treatment of glaucoma . Although clinical trials demonstrated a very strong benefit from using timolol as a migraine preventive , neither it nor propranolol have demonstrated efficacy as an acute treatment for migraine . However , these previous studies have focused on oral preparations of these drugs and the drug was not absorbed quickly enough to be effective as an acute treatment . Interestingly , since the 1980s , there have been rare case reports of patients with glaucoma being treated with timolol eye drops who experienced migraine relief .
16 HeadWise ® | Volume 5 , Issue 1 • 2015