Table 1.

β-Blockers in migraine prophylaxis

Daily dose range (the most effective dose or dose range is shown in parentheses) Propranolol hydrochloride (should be specifically considered as first-line agent)*: 40 to 320 mg (80-240 mg) Timolol maleate (should be specifically considered as first-line agent)*: 20 to 30 mg Nadolol: 40 to 240 mg Metoprolol tartrate: 50 to 300 mg (200 mg) Atenolol: 50 to 200 mg (100 mg) Side effects Fatigue Bradycardia Dizziness Depression Impotence Bronchospasm Nausea (adverse effects are less frequent than with the other first-line agents) Precautions Asthma Chronic heart failure Diabetes mellitus Peripheral vascular disease Conduction defects or heart block Depression Raynaud's disease Hypotension Special indications Concurrent hypertension Angina Post myocardial infarction Tremor Anxiety or panic attacks (specifically propranolol)

^*Approved by the Food and Drug Administration for migraine prevention