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Several studies and guidelines published in 2025 offer helpful information for clinicians who care for patients with migraine headaches.
Angiotensin-receptor blockers (ARBs) have long been listed among the options for migraine prophylaxis, but large studies were lacking, and primary care clinicians rarely use ARBs for this purpose. To address this gap, researchers randomized 460 normotensive patients who averaged 6 migraine days monthly to receive the ARB candesartan (either 8 or 16 mg) or placebo. After 3 months, 50% of candesartan recipients (with either dose) experienced a ≥50% reduction in monthly migraine days — compared with 28% of placebo recipients. Notably, dizziness was reported in 30% of candesartan recipients, so we should pay at…