Blood Pressure Drug Appears to Prevent Migraines
In this study, funded by one lisinopril manufacturer, AstraZeneca, Schrader and colleagues treated almost 50 patients with either lisinopril or a placebo for a 12-week period. They then switched the medications so that those formerly on the placebo received the active drug for a 12-week period and those formerly given lisinopril received the placebo. Participants were asked to record their total hours with headache, days with headache, and days with migraine in a diary. They also recorded which medicine they used to treat headaches and days they missed from work due to headaches.
In nearly a third of the patients, symptoms were reduced by half while on lisinopril. These patients also had fewer overall days with migraine.
Schrader says, that although it is difficult to compare this study with other studies, because it is so different, "[It] appears to us that the effectiveness of this agent is in the same range as beta-blockers and [the anti-seizure drug] sodium valproate."
Mathew says larger studies are needed to determine whether ACE inhibitors like lisinopril are a better choice for the prevention of migraines than medications that are now commonly prescribed. He says that migraine patients now have more choices than ever for both the prevention and treatment of their headaches.
"The field of migraine treatment has changed completely in the last 15 or 20 years," he says. "The majority of patients with migraines can be managed very well. The main problem today is that many physicians haven't kept up and don't know how to treat migraines. The most common mistake is to treat a migraine like any other pain."
Mathew says the most important thing a patient can do is find a doctor who is knowledgeable about the treatment of migraines.
"Patients are often given pain medications and combinations of medicines that are not appropriate for the treatment of migraines," he says. "If you fracture your arm, you are given morphine or codeine for the pain, but the same approach should not be applied to migraines. There are very good [medications that are best for migraines] out there, and there is no excuse for a doctor not to know about them."