Based on their analysis of the studies, the researchers concluded that approved drugs and off-label angiotensin-inhibiting drugs (lisinopril, captopril and candesartan), or off-label beta blockers (metoprolol, acebutolol, atenolol and nadolol) were effective in preventing episodic migraines in adults.
Off-label angiotensin-inhibiting drugs showed the most favorable combination of benefits to potential harms. The U.S. Food and Drug Administration permits physicians to prescribe approved medications for purposes other than their intended indications, and that practice is known as off-label use.
The study also found that there's a lack of research available about the long-term effects of drug treatments, especially on quality of life.
In treating migraines, off-label medications are frequently used, said Rosenberg. "In my practice I'm prescribing off-label as much as on-label." This, while state-of-the-art, should be a call to action, he added. "It's totally unacceptable that all the drugs we're using were invented for other diseases."
Learn more about migraines from the U.S. National Library of Medicine.
SOURCES: Tatyana Shamliyan, M.D., M.S., senior research associate, Minnesota Evidence-Based Practice Center, division of health policy and management, University of Minnesota, Minneapolis; Jason Rosenberg, M.D., assistant professor, neurology, and director, Headache Center, Johns Hopkins Medicine, Baltimore; April 2013, Journal of General Internal Medicine, online
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