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Efficacy of Enalapril in Migraine Prophylaxis: A Randomized, Double-blind, Placebo-controlled Trial

Background: Some angiotensin converting enzyme (ACE) inhibitors have previously been shown to be effective in migraine prophylaxis. The aim of this study was to evaluate whether Enalapril is effective in migraine prophylaxis. Methods: In this randomized, double-blind, placebo-controlled clinical trial, the effects of 10 mg Enalapril given daily were compared with those of matched placebo in 40 migraineurs for 2 months. Response to treatment was assessed at 0, 1, and 2 months after the start of intervention according to headache parameters like frequency, severity, and duration. This trial is registered with Iranian Registry of Clinical Trials (IRCT), number IRCT138711011570N1. Results: A significant effect on reducing migraine attack more than 50% at first and second months (P=0.016) occurred in Enalapril group. Indeed, at the first and second months of treatment, the severities (P=0.000 and P=0.000) and duration (P=0.037 and 0.003) in the Enalapril treated group were significantly lower than in the placebo group. Conclusion: Enalapril may be effective in migraine prophylaxis according to its effect in decreasing the frequency, severity, and duration of headaches. The results support the previous suggestions on usage of ACE inhibitors in migraine prophylaxis.