The use of propranolol as migraine prophylaxis
| Citation | Study group | Study type (level of evidence) | Outcome | Key results | Comments |
|---|---|---|---|---|---|
| Ludviggson (1974), Sweden | 32 children with IHS-congruent migraine (aged 7–16 years) Propranolol 60–120 mg daily divided in 3 doses v placebo, 3/12 period | Double-blind, crossover RCT (level 2c) | Increased perception of benefit of propranolol v placebo | Pre-crossover results: 13/13 (100%) improved with propranolol v 4/15(27%) with placebo; p<0.001; NNT = 1.4 | Reliability may be limited because very small trial with 13% of children lost to follow-up |
| Forsythe et al (1984), UK | 53 children with IHS-congruent migraine (aged 9–15 years) Propranolol 40–120 mg daily v placebo, 30 week period | Double-blind, crossover RCT (level 2c) | Propranolol significantly increased headache duration compared with placebo | Pre-crossover results: mean duration of headache: 436 minutes with propranolol v 287 minutes with placebo, p<0.01 | Reliability may be limited because only 74% of children completed the study |
| Olness et al (1987), USA | 33 children with IHS-congruent migraine (aged 6–12 years) Propranolol 3 mg/kg/day v placebo, 3/12 period | Double-blind, crossover RCT (level 2c) | No significant difference in the number of episodes of migraine between propranolol and placebo at 3/12 | Pre-crossover results Mean number of headaches: propranolol 14.9 (95% CI 2, 27.8) v placebo 13.3 (95% CI 3.8, 22.8), p = 0.47 | Confounding effect: In five participants in whom migraine was thought to be provoked by food, diet was restricted to avoid these foods Reliability also limited by 15% drop-out rate |