Beta blockers

Beta-blocker are among the first choice of medications for migraine prophylaxis, partly because they are easy to tolerate.


Metoprolol is a beta-blocker which is used for treatment of high blood pressure and for migraine prophylaxis. Metoprolol blocks the beta-receptors and thus prevents the effect of adrenalin on the heart. The heart beat is lower and less powerful which lowers the blood pressure. At the same time, the heart muscle uses less energy and oxygen. Since Metoprolol slows down the heart rate it can also positively affect cardiac arrhythmia if it is caused by a rapid heartbeat.

Metoprolol is among the first choice for migraine prophylaxis by now.

The following side effects occur occasionally or rarely:

–          Poor circulation in hands and feet

–          Fatigue

–          Insomnia, sleeping disorder

–          Bronchospasm, do not take Metoprolol if you have asthma

–          Bradycardia, slowing down of the heartbeat to under 60 bpm


Propranolol is a beta-blocker which is used for treatment of high blood pressure as well as migraine. It is also, just as Metoprolol, among the first choice of medication. Propranolol constricts specific vessels which are widened too much during a migraine back to normal.

Possible side effects are:

–          Fatigue

–          Insomnia, sleeping disorder

–          Depression

–          Increased liver enzyme levels, very rarely

–          Worsening of diabetes mellitus, very rarely

During pregnancy and while breat feeding, beta-blockers should only be taken if strictly indicated and in agreement with the doctor.