Candesartan for Preventing Episodic Migraine

Primary care clinicians often prescribe beta-blockers — and sometimes selected antidepressants or antiepileptics — for patients with frequent migraine headaches who require daily prophylaxis (see Figure 1). However, these agents are limited by drug-specific adverse effects.

Candesartan, an angiotensin-receptor blocker, is mentioned as a treatment option in some guidelines, based on small trials. Now, researchers have conducted a larger randomized trial in which 460 adults with 2 to 8 migraine days per month (mean, 6 days) received candesartan 16 mg, candesartan 8 mg, or placebo daily for 3 months. Importantly, patients taking hypertensive drugs were excluded.