• migraine;
  • anticoagulation;
  • acenocoumarol;
  • migraine prophylaxis

Objective.—To investigate the effect of low-intensity acenocoumarol treatment (target INR 1.5 to 2.0) on the frequency and severity of migraine attacks.

Background.—The positive effect of anticoagulation on migraine has been described in case reports and observational studies.

Methods.—We conducted a randomized, open, crossover study in migraine patients. After a run-in period of 8 weeks, all patients received acenocoumarol or propranolol during a period of 12 weeks and, after a washout period of 2 weeks, propranolol or acenocoumarol during a second period of 12 weeks.

Results.—Nineteen patients fulfilling the criteria were included. In 12 patients with complete data collection, only one good responder could be noted. In the other patients, treatment with low-intensity acenocoumarol did not show improvement of migraine symptoms compared with the run-in period. Treatment with propranolol showed a trend towards improvement compared with the run-in period. No serious adverse events were observed.

Conclusions.—Overall, low-intensity acenocoumarol treatment has no prophylactic effect in migraine patients.