Table 30Comparative safety of beta blockers for episodic migraine prevention in adults, treatment discontinuation due to bothersome adverse effects in randomized controlled clinical trials

Definition of the OutcomeReferenceActive DrugControl DrugSampleRate of Outcome in Active Group [Rate of Outcome in Control Group], PercentNumber Needed To Treat To Harm One Patient (95% CI)Attributable Events per 1,000 Treated (95% CI)Strength of Evidence
Withdrew because of side effects and/or lack of efficacyLouis, 1985207MetoprololClonidine620.0 [12.9]−8 (4 to 870)−129 (1 to 257)Low
Discontinued due to side-effectsWorz, 1991204MetoprololBisoprolol1566.4 [10.3]NSNSLow
Patient withdrawal due to eventsSchellenberg, 2008206MetoprololNebivolol307. [6.3]NSNSLow
Drowsiness leading to withdrawalGrotemeyer, 1990202MetoprololAspirin567.1 [0.0]NSNSLow
Gastrointestinal side-effects leading to withdrawalGrotemeyer, 1990202MetoprololAspirin560.0 [17.9]−6 (3 to 35)−179 (28 to 329)Low
Discontinued treatment because of severe adverse reactionsLangohr, 1985250ClomipramineMetoprolol12628.6 [0.0]3 (3 to 6)286 (173 to 399)Low

CI = confidence interval; NS = not significant

Bold = significant differences at 95% confidence limit when 95% CI of attributable events per 1,000 treated do not include 0.

Number needed to treat and number of attributable events were calculated for statistically significant differences.

From: Results

Cover of Migraine in Adults: Preventive Pharmacologic Treatments
Migraine in Adults: Preventive Pharmacologic Treatments [Internet].
Comparative Effectiveness Reviews, No. 103.
Shamliyan TA, Kane RL, Taylor FR.

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