Starting as a serendipitous side effect in 1967, the mystery of the efficacy of some beta-blockers in the prevention of migraine has not dimmed.
As migraine research carries on as a highly-scattered and increasingly multi-pronged process, it is important to underscore what we know, what we do not know, and what we might have missed by an exclusive pathophysiologic hyperfocus on the brain with varied hypotheses and postulations in terms of pharmacologic beta-blockade (and several other theories, including cortical spreading depression [CSD] ).
There is an intellectual cost for every assumption -- a feature that migraine researchers, have, in general, ignored.
In a very complex theoretical and practical conundrum or Gordian knot, we can only proceed by stages to unravel what we have assumed as truth / half-truth.
Do beta-blockers have any anti-serotonin / serotonolytic action? Or are these phamacotherapeutic agents serotonomimetic? Yet again, are beta-blockers clinically-neutral to serotonin?
50 years have passed without resolution of this impasse.
We are not prepared to accept science, as it is.
Migraine is a largely-unilateral (70-80%) phenomenon.
Over the last 100 years, migraine researchers have desperately tried to blur this fundamental principle of primary research. Hippocrates, 25 centuries ago, deducted or inferred what explosive technology in the recent decades sought to blur.
What unilateral cranial influence can propranolol exert to prevent migraine attacks?
Without opening this scientific door / component of primary headache, migraine research will forever remain obfuscated.
ORCID ID: 0000-0002-6770-5916
28-DEC-2023
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