CQ 1 CQ 2 334

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2012 8 31 2012 8 31 1 2 2012 9 CQ 1 CQ 2 334

CQ 4 4 CQ 24 11 6 2013 ; 39 3 : 297-302 335 CQ 3

CQ 1 2,1. 1 1. A 1 1 1 46 Holroyd 53 2,403 2 160 mg/ 43.7 14.3 p 0.001 44 65 14-3, 4 timolol 5 6 336

7 intrinsic sympathomimetic activity ISA flunarizine 8 9 10 11 European Federation of Neurological Science EFNS 40 240 mg/ A 12 American Academy of Neurology A 13, 14 1 Ayata C, Jin H, Kudo C, Dalkara T, Moskowitz MA : Suppression of cortical spreading depression in migraine prophylaxis. Ann Neurol 2006 ; 59 4 : 652-661. 2 Holroyd KA, Penzien DB, Cordingley GE : Propranolol in the management of recurrent migraine : a meta-analytic review. Headache 1991 ; 31 5 : 333-340. 3 Kangasniemi P, Andersen AR, Andersson PG, Gilhus NE, Hedman C, Hultgren M, Vilming S, Olesen J : Classic migraine : effective prophylaxis with metoprolol. Cephalalgia 1987 ; 7 4 : 231-238. 4 Steiner TJ, Joseph R, Hedman C, Rose FC : Metoprolol in the prophylaxis of migraine : parallel-groups comparison with placebo and dose-ranging follow-up. Headache 1988 ; 28 1 : 15-23. 5 Stellar S, Ahrens SP, Meibohm AR, Reines SA : Migraine prevention with timolol. A double-blind crossover study. JAMA 1984 ; 252 18 : 2576-2580. 6 Johannsson V, Nilsson LR, Widelius T, Javerfalk T, Hellman P, Akesson JA, Olerud B, Gustafsson CL, Raak A, Sandahl G, et al : Atenolol in migraine prophylaxis a double-blind cross-over multicentre study. Headache 1987 ; 27 7 : 372-374. 7 Ryan RE Sr : Comparative study of nadolol and propranolol in prophylactic treatment of migraine. Am Heart J 1984 ; 108 4 Pt 2 : 1156-1159. 8 Diener HC, Matias-Guiu J, Hartung E, Pfaffenrath V, Ludin HP, Nappi G, De Beukelaar F : Efficacy and tolerability in migraine prophylaxis of flunarizine in reduced doses : a comparison with propranolol 160 mg daily. Cephalalgia 2002 ; 22 3 : 209-221. 9 Kaniecki RG : A comparison of divalproex with propranolol and placebo for the prophylaxis of migraine without aura. Arch Neurol 1997 ; 54 9 : 1141-1145. 10 Diener HC, Tfelt-Hansen P, Dahlof C, Láinez MJ, Sandrini G, Wang SJ, Neto W, Vijapurkar U, Doyle A, Jacobs D ; MIGR-003 Study Group : Topiramate in migraine prophylaxis results from a placebo-controlled trial with propranolol as an active control. J Neurol 2004 ; 251 8 : 943-950. 11 Ziegler DK, Hurwitz A, Hassanein RS, Kodanaz HA, Preskorn SH, Mason J : Migraine prophylaxis. A comparison of propranolol and amitriptyline. Arch Neurol 1987 ; 44 5 : 486-489. 12 Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, Sándor PS : European Federation of Neurological Societies. EFNS guideline on the drug treatment of migraine revised report of an EFNS task force. Eur J Neurol 2009 ; 16 9 : 968-981. 13 Silberstein SD : Practice parameter : evidence-based guidelines for migraine headache an evidence-based review : report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2000 ; 55 6 : 754-762. 14 Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update : Pharmacologic treatment for episodic migraine prevention in adults : Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012 ; 78 17 : 1337-1345. DB PubMed 2012/8/31 1. {migraine} OR {vascular headache} OR {hemicrania} 71380 & propranolol 633 & metoprolol 149 & timolol 62 & nadolol 41 & atenolol 102 2. {migraine} OR {vascular headache} OR {hemicrania} & {propranolol} & flunarizine 72 & valproate 61 & topiramate 63 & amitriptyline 84 3 12-14 CQ 1 337

CQ 2 2,,,,.,, 1. A 1 2 1 1 1 2-9 3-5 1 338

2-12 13 1 Holroyd KA, Penzien DB, Cordingley GE : Propranolol in the management of recurrent migraine : a meta-analytic review. Headache 1991 ; 31 5 : 333-340. 2 Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E : Evidence-based guideline update : NSAIDs and other complementary treatments for episodic migraine prevention in adults : Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012 ; 78 17 : 1346-1353. 3 Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E : Evidence-based guideline update : pharmacologic treatment for episodic migraine prevention in adults : report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012 ; 78 17 : 1337-1345. 4 Silberstein SD : Practice parameter : evidence-based guidelines for migraine headache an evidence-based review : report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2000 ; 55 6 : 754-762. 5 Ramadan NM, Silberstein SD, Freitag FG, Gilbert TT, Frishberg BM : Evidence-based guidelines for migraine headache : pharmacological management for prevention of migraine. Available at : http://www.aan.com/professionals/practice/pdfs/ gl0090.pdf accessed 13 December 2011 6 Guidelines and recommendations for the treatment of migraine. Italian Society for the Study of Headache SISC. Funct Neurol 1993 ; 8 6 : 441-446. 7 Snow V, Weiss K, Wall EM, Mottur-Pilson C : Pharmacologic management of acute attacks of migraine and prevention of migraine headache. Ann Intern Med 2002 ; 137 10 : 840-849. 8 Géraud G, Lantéri-Minet M, Lucas C, Valade D. French guidelines for the diagnosis and management of migraine in adults and children. Clin Ther 2004 ; 26 8 : 1305-1318. 9 Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, Sándor PS ; European Federation of Neurological Societies : EFNS guideline on the drug treatment of migraine revised report of an EFNS task force. Eur J Neurol 2009 ; 16 9 : 968-981. 10 Pryse-Phillips WE, Dodick DW, Edmeads JG, Gawel MJ, Nelson RF, Purdy RA, et al : Guidelines for the diagnosis and management of migraine in clinical practice. Canadian Headache Society. CMAJ 1997 ; 156 9 : 1273-1287. 11 Guidelines for the management of headache. Danish Neurological Society and the Danish Headache Society. Cephalalgia 1998 ; 18 1 : 9-22. 12 Treatment guidelines for preventive treatment of migraine. Treatment Guideline Subcommittee of the Taiwan Headache Society. Acta Neurol Taiwan 2008 ; 17 2 : 132-148. 13 Bidabadi E, Mashouf M : A randomized trial of propranolol versus sodium valproate for the prophylaxis of migraine in pediatric patients. Paediatr Drugs 2010 ; 12 4 : 269-275. DB PubMed 2012/9/10 migraine & propranolol 521 & guideline 14 & benefit 25 & prophylaxis 258 & preventive 44 CQ 2 339

CQ 3 20~30 mg/, 60 mg/,1 2 3. A 2012 8 31 80 240 mg/ 80 160 mg/ 30 60 mg/ Holroyd 53 2,403 1 160 mg/ 43.7 14.3 p 0.001 44 65 14 - European Federation of Neurological Science EFNS 40 240 mg/ A 2 3-5 120 240 mg/ 30 60 mg/ 340

6-8 2006 20 60 mg/ 9, 10 16 20 40 mg/ 29.4 4.4 mg/ 1 2 36.8 6 10. 1 Holroyd KA, Penzien DB, Cordingley GE : Propranolol in the management of recurrent migraine : a meta-analytic review. Headache 1991 ; 31 5 : 333-340. 2 Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, Sándor PS ; European Federation of Neurological Societies : EFNS guideline on the drug treatment of migraine revised report of an EFNS task force. Eur J Neurol 2009 ; 16 9 : 968-981. 3 Silberstein SD : Practice parameter : evidence-based guidelines for migraine headache an evidence-based review : report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2000 ; 55 6 : 754-762. 4 Ramadan NM, Silberstein SD, Freitag FG, Gilbert TT, Frishberg BM : Evidence-based guidelines for migraine headache : pharmacological management for prevention of migraine. Available at : http://www.aan.com/professionals/practice/pdfs/ gl0090.pdf accessed 13 December 2011 5 Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E : Evidence-based guideline update : Pharmacologic treatment for episodic migraine prevention in adults : Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012 ; 78 17 : 1337-1345. 6 Inderal 1980 ; 8 9 : 3497-3503. 7 1985 ; 13 4 : 2489-2493. 8 propranolol 1989 ; 21 3 : 1001-1005. 9 2011 ; 38 2 : 201. 10 2011 ; 38 2 : 203. DB PubMed 2012/8/31 {migraine} OR {vascular headache} OR {hemicrania} 71380 & propranolol 633 DB 12/8/31 ( ) & ( ) 67 4 3-5, 6 CQ 3 341

CQ 4,, 1966,.,.,,. A 1966 1 2 3 Holroyd 2,403 1 60 mg 342

4 2 1, 5 AUC 1.67 Cmax 1.75 6 MAO-A 7 AUC Cmax 8 1 1 10 mg 20 mg 2012 5 11 2 Limmroth V, Michel MC : The prevention of migraine : a critical review with special emphasis on -adrenoceptor blockers. Br J Clin Pharmacol 2001 ; 52 3 : 237-243. 3 Holroyd KA, Penzien DB, Cordingley GE : Propranolol in the management of recurrent migraine : a meta-analytic review. Headache 1991 ; 31 5 : 333-340. 4 Taylor FR : Weight change associated with the use of migraine-preventive medications. Clin Ther 2008 ; 30 6 : 1069-1080. 5 10 mg RPD 10 mg 2009 6 7 6 Goldberg MR, Sciberras D, Smet MD, Lowry R, Tomasko L, Lee Y, Olah TV, Zhao J, Vyas KP, Halpin R, Kari PH, James I : Influence of -adrenoceptor antagonists on the pharmacokinetics of rizatriptan, a 5-HT1B/1D agonist : differential effects of propranolol, nadolol and metoprolol. Br J Clin Pharmacol 2001 ; 52 1 : 69-76. 7 Peck RW, Seaber EJ, Dixon R, Gillotin CG, Weatherley BC, Layton G, Posner J : The interaction between propranolol and the novel antimigraine agent zolmitriptan 311C90. Br J Clin Pharmacol 1997 ; 44 6 : 595-599. 8 Scott AK, Walley T, Breckenridge AM, Lacey LF, Fowler PA : Lack of an interaction between propranolol and sumatriptan. Br J Clin Pharmacol 1991 ; 32 5 : 581-584. DB PubMed 2012/9/3 Migraine & propranolol & side effect 26 Migraine & propranolol & interaction 19 CQ 4 343