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Original Research
Online Published: 05 Oct 2026
 
RMJ. 2026; 51(4): 987-990


Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine

Muhammad Bilal Ahmad Shafiq, Muhammad Usman Choudhary, Muhammad Amin Khan, Javaria Amil, Tehreem Batool, Safia Bano.


Abstract
Objective: To compare the efficacy of propranolol monotherapy versus combined therapy with propranolol and levetiracetam in reducing migraine frequency, severity, and disability.
Methodology: This prospective open-label comparative study was conducted at the Department of Neurology, Niazi Welfare Foundation Teaching Hospital, Sargodha, from 1st November 2024 to 31st January 2026. A total of 128 patients (64 per group), aged 18–40 years and diagnosed with episodic or chronic migraine, were enrolled. Participants were allocated in a 1:1 ratio to receive either propranolol (40–80 mg/day) alone (Group A) or propranolol (40–80 mg/day) combined with levetiracetam (500–1000 mg/day) (Group B). Outcomes were assessed at baseline, 4 weeks, and 8 weeks using monthly attack frequency, Visual Analogue Scale (VAS), and Migraine Disability Assessment Scale (MIDAS) scores. Data were analyzed using the Mann–Whitney U test, with p<0.05 considered significant.
Results: Baseline characteristics and outcome measures were comparable between groups (p>0.05). Combination therapy (Group B) demonstrated superior improvement compared to monotherapy, with significant reductions in attack frequency (p<0.001), MIDAS scores at 4 and 8 weeks (p<0.001), and VAS scores at 4 weeks (p=0.014) and 8 weeks (p<0.001).
Conclusion: Combined propranolol and levetiracetam therapy was more effective than monotherapy with propranolol alone in migraine prophylaxis, supporting a multi-targeted therapeutic approach.

Key words: Headache, levetiracetam, migraine, photophobia, propranolol.


 
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How to Cite this Article
Pubmed Style

Shafiq MBA, Choudhary MU, Khan MA, Amil J, Batool T, Bano S. Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. RMJ. 2026; 51(4): 987-990.

Web Style

Shafiq MBA, Choudhary MU, Khan MA, Amil J, Batool T, Bano S. Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. https://www.rmj.org.pk/?mno=311463 [Access: November 11, 2026].

AMA (American Medical Association) Style

Shafiq MBA, Choudhary MU, Khan MA, Amil J, Batool T, Bano S. Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. RMJ. 2026; 51(4): 987-990.


Vancouver/ICMJE Style

Shafiq MBA, Choudhary MU, Khan MA, Amil J, Batool T, Bano S. Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. RMJ. (2026), [cited November 11, 2026]; 51(4): 987-990.


Harvard Style

Shafiq, M. B. A., Choudhary, . M. U., Khan, . M. A., Amil, . J., Batool, . T. & Bano, . S. (2026) Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. RMJ, 51 (4), 987-990.


Turabian Style

Shafiq, Muhammad Bilal Ahmad, Muhammad Usman Choudhary, Muhammad Amin Khan, Javaria Amil, Tehreem Batool, and Safia Bano. 2026. Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. Rawal Medical Journal, 51 (4), 987-990.


Chicago Style

Shafiq, Muhammad Bilal Ahmad, Muhammad Usman Choudhary, Muhammad Amin Khan, Javaria Amil, Tehreem Batool, and Safia Bano. "Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine." Rawal Medical Journal 51 (2026), 987-990.


MLA (The Modern Language Association) Style

Shafiq, Muhammad Bilal Ahmad, Muhammad Usman Choudhary, Muhammad Amin Khan, Javaria Amil, Tehreem Batool, and Safia Bano. "Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine." Rawal Medical Journal 51.4 (2026), 987-990. Print.


APA (American Psychological Association) Style

Shafiq, M. B. A., Choudhary, . M. U., Khan, . M. A., Amil, . J., Batool, . T. & Bano, . S. (2026) Comparing the efficacy of propanolol alone versus propanolol combined with levetiracetam as preventive therapy for migraine. Rawal Medical Journal, 51 (4), 987-990.



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