The pathophysiology of both classical and common migraine is still not understood, and there is controversy as to whether the origin is vascular, neuronal, or both. Although the mechanism for the prophylactic effect of β-blockers in migraine has not been elucidated yet, the therapeutic action of β1-blockers and non-selective β-blockers devoid of intrinsic activity is well established by many controlled trials. Mainly on the basis of data from animal experiments, the possible role of central β-adrenoceptor-mediated mechanisms involved in the control of the activity of noradrenergic neurons will be discussed with reference to migraine.
WolffHH. Headache and other pain. New York: Oxford University Press1963:227–386.
2.
OlesenJLarsenBLauritzenM. Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in classical migraine. Ann Neurol1981;9:344–52.
3.
OlesenJTfelt-HansenPHenriksenLLarsenB. The common migraine attack may not be initiated by cerebral ischemia. Lancet1981;2:438–40.
4.
LeäoAAP. Spreading depression of activity in the cerebral cortex. J Neurophysiol1944;7:359–90.
5.
LauritzenMSkyhöjOlsen TLassenNAPaulsonOB. Changes in regional cerebral blood flow during the course of classical migraine attack. Ann Neurol1983;13:633–41.
6.
LanceJWLambertGAGodsleyPJDucksworthJW. Brainstem influences on the cephalic circulation: experimental data from cat and monkey of relevance to the mechanisms of migraine. Headache1983;23:258–65.
7.
ShanksRG. Mechanism of action of beta-adrenoceptor antagonists in migraine. In: CarrollJDPfaffenrathVSjaastadO, ed. Migraine in beta-blockade. Mölndal, Sweden: Hässle1985:45–53.
8.
KangasniemiPHedmanC. Metoprolol and propranolol in the prophylactic treatment of classical and common migraine. A double-blind study. Cephalalgia1984;4:91–6.
9.
OlssonJ-EBehringHCForssmanBHedmanCHedmanGJohanssonFKinnmanJPålhagenS-ESamuelssonMStrandmanE. Metoprolol and propranolol in migraine prophylaxis: a double-blind multicentre study. Acta Neurol Scand1984;70:160–8.
10.
StensrudPSjaastadO. Comparative trial of tenormin (atenolol) and inderal (propranolol) in migraine. Headache1980;20:204–7.
11.
Tfelt-HansenPStanduesBKangasniemiPHakkarainenHOlesenJ. Timolol vs propranolol vs placebo in common migraine prophylaxis—a double-blind multicenter trial. Acta Neurol Scand1984;64:1–9.
12.
KenakinTPBeekD. Is prenalterol (H 133/22) really a selective beta-1-adrenergic agonist? Tissue selectivity resulting from differences in stimulus-response relationships. J Pharmacol Exp Ther1980;213:406–13.
13.
RahnKHHawlinaAKerstingFPlanzG. Studies on the antihypertensive action of the optical isomers of propranolol in man. Naunyn Schmiedebergs Arch Pharmacol1974;286:319–23.
14.
Waal-ManningHJ. Lack of effect of d-propranolol on blood pressure and pulse rate in hypertensive patients. Proc Univ Otago Med School1970;48:80–1.
15.
StensrudPSjaastadO. Short-term clinical trial of propranolol in racemic form (Inderal), d-propranolol and placebo in migraine. Acta Neurol Scand1976;53:229–32.
16.
Tfelt-HansenP. Efficacy of β-blockers in migraine—a critical review. Cephalalgia1986;6(suppl 5): 15–24.
17.
NahorskiSRWillcocksAL. Interactions of β-adrenoceptor antagonists with 5-hydroxytryptamine receptor subtypes in rat cerebral cortex. Br J Pharmacol1983;78:1071.
18.
MiddlemissDN. Stereoselective blockade at [3H]5-HT binding sites and at the 5-HT autoreceptor by propranolol. Eur J Pharmacol1984;101:289–93.
19.
GreenARJohnsonPNimgaonkarVL. Interactions of β-adrenoceptor agonists and antagonists with the 5-hydroxytryptamine (5-HT-) receptor. Neuropharmacology1983;22:657–60.
20.
DahlöfC. Studies on β-adrenoceptor mediated facilitation of sympathetic neurotransmission [Thesis]. Acta Physiol Scand1981(suppl 500).
21.
LangerSZ. Presynaptic regulation of the release of catecholamines. Pharmacol Rev1981;32:337–62.
22.
DahlöfCÅbladBBorgKOEkLWaldeckB. Prejunctional inhibition of adrenergic nervous vasomotor control due to β-receptor blockade. In AlmgrenOCarlssonAEngleJ, eds Chemical tools in catecholamine research II. Amsterdam: North Holland Publishing Co. 1975, 201–10.
23.
CarlssonEÅbladBBrändströmACarlssonB. Differentiated blockade of the chronotropic effects of various adrenergic stimuli in the cat heart. Life Sci1972;11:953–8.
24.
CarlssonE. On the classification and distribution of β-adrenoceptors. Acta Pharmacol Toxicol1979;44(suppl II):17–20.
25.
KornerPI. The mechanisms of action of beta-adrenoceptor antagonists and the role of central and peripheral beta-adrenoceptors in blood pressure regulation: a status report. In KalsnerS ed Trends in autonomic pharmacology. Vol 2. 1982:441–56.
26.
AndersonWPKornerPIBobikAChalmersJP. Leakage of dl-propranolol from cerebrospinal fluid to the bloodstream in the rabbit. J Pharmacol Exp Ther1977;202(2):320–5.
27.
PhilippuAStroehlU. Beta-adrenoceptors of the posterior hypothalamus. Clin Exp Hypertens1978;1:25–38.
28.
PhilippuA. Regulation of the arterial blood pressure. In: SzekeresL, ed Adrenergic activators and inhibitors. Part I. Springer-Verlag, Berlin, 1980, 521–48.
29.
SharmaJNSandrewBBWangSC. CNS site of β-adrenergic blocker-induced hypotension in the cat: a microiontophoretic study of bulbar cardiovascular neurons. Neuropharmacology1979;18:1–5.
30.
JohnsonES. A basis for migraine therapy—the autonomic theory reappraised. Postgrad Med J1978;54:231–42.
31.
FooteSLBloomFEAston-JonesG. Nucleus locus ceruleus: new evidence of anatomical and physiological specificity. Physiol Rev1983;63:844–64.
32.
DahlöfCEngbergGSvenssonTS. Effects of β-adrenoceptor antagonists on the firing rate of noradrenergic neurons in the locus coeruleus of the rat. Naunyn Schmiedebergs Arch Pharmacol1981;317:26–30.
33.
RaineAEGChubbIW. Long-term β-adrenergic blockade reduces tyrosine hydroxylase and dopamine β-hydroxylase activities in sympathetic ganglia. Nature1977;267:265–7.
34.
DiamondSKudrowLStevensJShapiroDB. Long-term study of propranolol in the treatment of migraine. Headache1982;22:268–71.
35.
DahlöfCHednerJ. Långtidsprofylax mot migrän efter behandling med beta-blockerare?Lakartidningen1984;81:219.
36.
LjungBÅbladBAlmgrenODahlöfCErikssonB-M. Effects of metoprolol on adrenergic mechanisms during long- and short-term hypertensive treatment of spontaneously hypertensive rats. Acta Med Scand1979;625(suppl):36–40.
37.
HanbauerIKopinIJGuidottiACostaE. Induction of tyrosine hydroxylase elicited by beta adrenergic receptor agonists in normal and decentralized sympathetic ganglia: role of cyclic 3,5-adenosine monophosphate. J Pharmacol Exp Ther1975;193:95–104.
