Beta-Blockers for Migraines

Thanks for the review of migraines in the July 5 issue. I disagree on one point: The article states that beta-blockers should not be used in people with depression. The July 17 issue of the Journal of the American Medical Association carried an excellent review of beta-blockers and symptoms of depression, fatigue, and sexual dysfunction. The authors stated that there is no substantial risk of depression, and only a small risk of fatigue and sexual dysfunction. This finding fits with what I have observed in my practice for more than 15 years.

Editor’s note: The JAMA article referenced above is a review of clinical trial data. Postmarketing data have associated beta-blockers with an increased incidence of depression.