Candesartan for Treatment of Migraine Headache: A Scoping Review.

PURPOSE: Migraine is a prevalent and debilitating disorder, ranked as the third leading cause of global disability. Given its significant health and financial impact, exploring alternative treatments is crucial. Candesartan, an angiotensin-receptor blocker, has shown potential as a management for migraine.

METHODS

A scoping review of literature on the efficacy and safety of candesartan in migraine treatment was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews guidelines.

FINDINGS: Thirty-eight articles were included in this review. Candesartan has shown promising results in preventing migraine, particularly in patients with comorbid conditions such as hypertension. Its mechanism may involve modulation of the central pain pathway and vascular functions. Clinical studies support its efficacy in reducing headache days, migraine hours, and related disability, with results comparable to those of established migraine treatments such as beta-blockers. Candesartan's favorable cost profile, once-daily dosing, and good tolerability further support its potential as a first-line treatment option.

IMPLICATIONS: Candesartan offers a promising addition as an effective and safe option for migraine treatment, but further research is necessary. Future studies should focus on its use for acute attacks, dose-response relationships, long-term safety, and cost-effectiveness.