propranolol

8 December 2016

Beta Blockers: Migraine

This information on beta blockers: migraine is a step back to some of the basics regarding migraine treatment. Just what are beta blockers, and why are they used for migraine?

Beta blockers, also called beta-adrenergic blocking agents, are medications used for both migraine and blood pressure issues. They work by blocking certain neurotransmitters (norephinephrine and epinephrine) so that they won’t bind to certain beta receptors on nerves.

In this way the drugs reduce your heart rate and reduce blood pressure by dilating blood vessels. Different beta blockers have a slightly different effect on your cardiovascular system.

Beta blockers for migraine are given as preventatives. Some of the most effective beta blockers for migraine are metoprolol, propranolol, and timolol.
beta-blockers-migraine In 1966, a patient using beta blockers for a heart condition experienced a dramatic improvement in migraine symptoms. In the 1970s, beta blockers started to be tested and used for migraine on a regular basis.

It’s easy to jump to the conclusion that the effect of beta blockers on the cardiovascular system is the direct reason why they prevent migraine. After all, we’re very familiar with that pounding, pulsing pain – why wouldn’t relaxing of the blood vessels help?

But of course it’s not that simple. Believe it or not, that pounding is not directly related to your heart beat. So today, migraine experts are not certain about just why some beta blockers help some patients.

Before taking beta blockers for migraine, your doctor will need to know your medical history. People with certain heart conditions, lung conditions, or those taking certain other medications, may not be able to take beta blockers. There are also other migraine treatments that you may want to try first.

Today, there are various beta blockers you can take for migraine, and there are various ways you can take them. If one doesn’t work, another might.

One of the most interesting recent discoveries is that beta blocker eye drops may even be effective abortive migraine-fighters! See $5 Eye Drops to Stop Migraine Attacks?

Common side effects of beta blockers include fatigue, weight gain, trouble sleeping, nausea, sexual dysfunction, and shortness of breath. Some of these will depend on the dosage and the type of beta blocker. Your doctor can help you choose what to try first.

For more information, see:

7 April 2016

What Does Tinnitus Sound Like?

James Information 4

Patients who have tinnitus hear something that’s not from an external source. It can be a ringing in the ears, a whooshing or roaring sound, or even a sort of beating or clicking sound.

Some types of migraine can lead to tinnitus, such as migraine with brainstem aura and vestibular migraine.

There are medications used for migraine which also may lead to tinnitus, such as propranolol or even aspirin. Marijuana and alcohol may also cause tinnitus.

But what is it like to have tinnitus? Can you imagine never enjoying silence – always having another sound in the background, taking your attention away from what’s going on? What does tinnitus sound like?

But what does tinnitus actually sound like? Well, the The National Institute for Health Research has gathered some examples from the British Tinnitus Association that you can listen to online. Just set your speakers to a normal listening level, and press “play” on any of the 11 sounds.

If you’re like me, you’ll be amazed. And you’ll have more empathy for those dealing with this symptom.

What Does Tinnitus Sound Like?

If you have tinnitus, tell us – which one is closest to your experience, or is/was yours totally different?

For more information on tinnitus:

3 December 2015

Atenolol for Vertigo – Is it Effective?

James Medications 0

Atenolol (brand name Tenormin) is a type of medication known as a beta blocker. Beta blockers are often used for cardiovascular diseases, such as hypertension (high blood pressure). But could it also be used for vertigo?

You won’t find atenolol for vertigo on most lists of medication for vertigo, and there are two reasons for that. But, as we will see, it is sometimes helpful in alleviating vertigo.

First, atenolol is not typically a medication used to suppress vertigo symptoms. In fact, beta blockers are not commonly thought of as vertigo treatments.

However, they are migraine treatments. That being said, atenolol is a less commonly prescribed migraine drug.

So atenolol is sometimes used to treat migraine – migraine with the symptom of vertigo. Treat the migraine, treat the vertigo.

However, you still won’t find it on most lists, because it’s not usually one of the first beta blockers to try.

Beta blockers that seem to be more effective for treating migraine (including migraine related vertigo) include propranolol, metoprolol and timolol. Atenolol also tends to be discouraged in pregnant women, seniors, and people with depression and diabetes (among other things).

The short answer is this: Medication for vertigo will depend on the cause of the vertigo. If the vertigo is related to migraine, your best bet is to treat the migraine disease itself. Beta blockers are an option (not necessarily the first option to try, however), and atenolol may be helpful. But your doctor will probably recommend you try other treatments first, before recommending atenolol for vertigo (for examples of higher rated treatments, including beta blockers, check out From Current Studies: What Migraine Treatments Work?).

For an overview of the drug treatments for vertigo, check Management of Dizziness and Vertigo. Also see Migraine-associated dizziness: patient characteristics and management options. and Atenolol in the prophylaxis of chronic migraine. Finally, here is a discussion including atenolol for vertigo in migraine.

1 May 2012

From Current Studies: What Migraine Treatments Work?

James Medications, News, Treatments 2

New guidelines have just come out based on the evidence we currently have for migraine treatment. We’ll talk about some of the guidelines in a moment, but first there are some key things to remember.

Caution: Dangerous Waters Ahead!

These guidelines were created by checking out the studies that have been published to date. This means that we do or do not have high quality studies that show successful treatment using [whatever medication or supplement]. If we don’t have enough quality studies, the item will be lower on the list.

We should also note that the guidelines are talking about what works in general, NOT what works for you or what is best for you. Some treatments high on the list are also high in side effects. Or they may be dangerous for certain people. Or they may not work well for your particular type of migraine. Do not take this as a list of what to try first. Something lower on the list may be something far better for you that something on the top.

This list also doesn’t address combo-treatments, such as MigreLief (with magnesium, feverfew and riboflavin).

The list does help doctors prioritize what to consider. If you’ve tried a number of things and haven’t tried something high on the list, it may be time to ask your doctor about it.

Highest rated treatments

Here are some of the highest rated treatments for migraine. There are four categories:

Over-the-counter: Petasites (butterbur) (such as Petadolex) (please note the current controversy over butterbur)
Triptans: frovatriptan (especially recommended for menstrual migraine)
Antiepileptics: divalproex sodium, sodium valproate, topiramate
beta-blockers: metoprolol, propranolol, timolol

Lowest rated treatments

These are the items that had a negative rating, meaning that they’re not recommended at this time: Lamotrigine, Clomipramine, Acebutolol, Clonazepam, Nabumetone, Oxcarbazepine, Telmisartan, montelukast.

Everything in-between

Of course, just because something isn’t on the top of the list doesn’t mean it’s not an excellent, helpful treatment for many people. For example, very close to the top were well-recognized treatments such as amitriptyline, zolmitriptan, feverfew, naproxen sodium, riboflavin (vitamin B2), and magnesium.

It should also be noted that Botox migraine treatment was not a part of these studies.

For some of the medications that are being used today, check out Migraine Medications: So many choices.

17 January 2011

Children’s Headaches – Should I Consider a Preventative Medication?

James Information, Medications 0

It’s a challenge to diagnose headache disorders, especially in younger children. But it’s becoming clear that it’s important, and more and more research is being done to help fight pediatric headaches.

Headaches are surprisingly common in children.

The catch is that sometimes even the children don’t really know how bad they are. The matter is further complicated when it comes to issues like migraine, where the symptoms can be so varied. Many people with migraine simply "don’t feel well", and have very little actual head pain. In children, abdominal migraine is common, where nausea may be the main symptom and the pain may be in the stomach.

It takes time to work with your doctor and child to uncover the symptoms and find a good treatment. But it’s important to do so. Catching headache disorders early can help avoid later complications. And children with frequent headaches can have extra trouble at school that can leave them farther behind than they need to be.

A preventative medication is something that your doctor may recommend if the headaches are frequent. The good news is, many medications have been found to really help children with migraine.

Some of the common medications that have helped children include:

Propranolol: A beta-blocker. Some brand names include Inderal, Avlocardyl, Inderalici, InnoPran XL, and Sumial
Flunarizine: A calcium-channel blocker. Brand names include Adalat, Cardizem, Isoptin, Nimotop, and Sibelium.
Topiramate: An anticonvulsant drug. Brand name Topamax.
Sodium valproate: An anticonvulsant. Brand names include Depakote, Epilim, Orlept, and Epival.
Amitriptyline: A tricyclic antidepressant. Brand names include Vanatrip, Elavil, and Endep.

Here are some things you and your doctor will want to consider when thinking about preventative medications:

How disabling are the symptoms? How often is the child having attacks? How is this impacting their daily life?
Are there other symptoms or co-existing disorders that could potentially be treated with the same medication? (For example, nausea, epilepsy, etc)
What are common risks and side effects associated with this medication? How will your doctor help you watch for these things over time?
Will a preventative medication help the child cut down on abortive medications? If you are giving your child "painkillers" more than twice a week, it’s very important you look for other options.
Is there a trial period? Is there a time when we could try taking the child off the preventative in the future?
What other treatments can be used alongside of (or instead of) the preventative medication? For example, changes in diet, biofeedback, an exercise program, CoQ10 etc.

In certain cases, preventative medications have helped children effectively fight headache and migraine symptoms. But do your homework, and remember that this is something you need to take one step at a time. Don’t expect an instant cure-all. But do expect to find a combination of treatments that works well.