Candesartan Versus Propranolol for Migraine Prevention

Inclusion Criteria:

• age 18 to 65 years

• retrospectively have ≥ 2 migraine attacks per month during the last 3 months

• during the baseline period have ≥ 2 migraine attacks

• debut of migraine at least one year prior to inclusion

• start of migraine before age 50 years.

Exclusion Criteria:

• interval headache not distinguishable from migraine

• chronic tension-type headache or other headache occurring on ≥ 15 days/month

• pregnancy, nursing or inability to use contraceptives

• heart conduction block on ECG or significant ECG abnormality on inclusion

• heart rate < 54 after 3 minutes rest

• previous or present asthma, diabetes; decreased hepatic or renal function

• hypersensitivity to active substance

• history of angioneurotic edema

• significant psychiatric illness

• use of daily migraine prophylactics less than 4 weeks prior to start of study

• having tried ≥ 3 prophylactic drugs against migraine during the last 10 years

• previous use of propranolol or candesartan in adequate doses

• previous discontinuation of either Atacand or Inderal Retard (or another beta blocker)due to side effects

• current use of antihypertensive medication

• require use of rizatriptan (Maxalt) 10 mg tabl.

• subjects requiring detoxification from acute medication (ergotamines, opioids)

• patients who consistently fail to respond to any acute migraine medication

• patients with alcohol or illicit drug dependence