Propranolol and venlafaxine for vestibular migraine prophylaxis

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Propranolol and venlafaxine for vestibular migraine prophylaxis
Key Take-Away: 

For a disease like migraine, prevention as a treatment approach is really important. This particular study grabs readers’ attention because investigators of this study have successfully compared the effectiveness of propranolol (beta blocker) and venlafaxine (SNRI) for vestibular migraine prevention. 

Propranolol is a well known beta blocker while venlafaxine belongs to SNRI category. We compared the effectiveness of venlafaxine and propranolol for the prophylaxis of vestibular migraine (VM).

ABSTRACT: 
Background: 

Propranolol is a well known beta blocker while venlafaxine belongs to SNRI category.

We compared the effectiveness of venlafaxine and propranolol for the prophylaxis of vestibular migraine (VM).

Methods: 

Sixty-four subjects with definite VM were enrolled. The subjects were randomly assigned to receive propranolol (group P, n = 33) or venlafaxine (group V, n = 31) for VM prophylaxis.

Dizziness Handicap Inventory (DHI) scores, the Vertigo Severity Score (VSS), and the number of vertiginous attacks were recorded before and 4 months after treatment. The Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores were also recorded to monitor the resolution of psychiatric symptoms.

Results: 

At 4 months after treatment, the DHI total score decreased from 55.8 ± 2.7 to 31.3 ± 3.7 and from 50.9 ± 2.5 to 19.9 ± 2.9 (P < .001), the mean number of total vertiginous attacks decreased from 12.6 ± 1.8 to 1.9 ± 0.7 and from 12.2 ± 1.8 to 2.6 ± 1.1 (P < .001), and VSS decreased from 7.3 ± 0.3 to 2.1 ± 0.4 and from 7.9 ± 0.3 to 1.8 ± 0.5 (P < .001) in groups P and V, respectively.

However, the treatment effects were similar in both groups (P > .05). BAI scores significantly decreased in both groups, whereas BDI scores decreased only in group V.

Conclusion: 

This study provided evidence that venlafaxine and propranolol show equal effectiveness as prophylactic drugs for ameliorating vertiginous symptoms in VM patients. However, venlafaxine may be superior to propranolol in ameliorating depressive symptoms.

Laryngoscope. 2015 Jul 30
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