Which of the following is a beta blocker used for migraine prophylaxis?

Prepare for the Pharmacology IV – Headache Therapeutics Test. Review the therapeutic approaches, tackle multiple-choice questions with explanations, and boost your test-taking confidence. Ace your exam with precision!

Multiple Choice

Which of the following is a beta blocker used for migraine prophylaxis?

Migraine prevention can be aided by drugs that blunt sympathetic influences and stabilize vascular and neural activity, and a classic choice among these is a nonselective beta-adrenergic blocker. Propranolol fits this role well: by blocking beta receptors, it reduces sympathetic modulation of cerebral blood flow and neuronal excitability, which helps lower the frequency of migraine attacks. It’s been studied extensively and is commonly recommended as a preventive option for episodic migraine. Start at a low dose and titrate up while monitoring heart rate and blood pressure; common ranges aim for around 80 mg per day or more, up to about 160 mg daily in divided doses, depending on tolerance and response. Be mindful of side effects—fatigue, bradycardia, hypotension—and avoid if there’s significant asthma/COPD risk (due to potential bronchospasm) or certain heart conditions. The other drugs listed are not beta blockers: candesartan is an angiotensin II receptor blocker, used for blood pressure control and studied for migraine prevention via vascular mechanisms but not a beta blocker. Rimegepant is a CGRP receptor antagonist used for migraine treatment and prevention but not a beta blocker. Fremanezumab is a CGRP-targeted monoclonal antibody used for prevention, also not a beta blocker. So propranolol is the beta blocker indicated for migraine prophylaxis.

Migraine prevention can be aided by drugs that blunt sympathetic influences and stabilize vascular and neural activity, and a classic choice among these is a nonselective beta-adrenergic blocker. Propranolol fits this role well: by blocking beta receptors, it reduces sympathetic modulation of cerebral blood flow and neuronal excitability, which helps lower the frequency of migraine attacks. It’s been studied extensively and is commonly recommended as a preventive option for episodic migraine. Start at a low dose and titrate up while monitoring heart rate and blood pressure; common ranges aim for around 80 mg per day or more, up to about 160 mg daily in divided doses, depending on tolerance and response. Be mindful of side effects—fatigue, bradycardia, hypotension—and avoid if there’s significant asthma/COPD risk (due to potential bronchospasm) or certain heart conditions.

The other drugs listed are not beta blockers: candesartan is an angiotensin II receptor blocker, used for blood pressure control and studied for migraine prevention via vascular mechanisms but not a beta blocker. Rimegepant is a CGRP receptor antagonist used for migraine treatment and prevention but not a beta blocker. Fremanezumab is a CGRP-targeted monoclonal antibody used for prevention, also not a beta blocker. So propranolol is the beta blocker indicated for migraine prophylaxis.

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