Propranolol migraine prophylaxis

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  1. Fyfa Well-Known Member

    Propranolol migraine prophylaxis


    This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Migraine, a significantly disabling condition, is treated with acute and preventive medications. However, some individuals are refractory to standard treatments. Although there is a host of alternative management options available, these are not always backed by strong evidence. In fact, most of the drugs used in migraine were initially designed for other purposes. Whilst effective, the benefits from these medications are modest, reflecting the need for newer and migraine-specific therapeutic agents. In recent years, we have witnessed the emergence of novel treatments, of which noninvasive neuromodulation appears to be the most attractive given its ease of use and excellent tolerability profile. Choosing a therapeutic agent that is best for each individual patient requires consideration of the patient's history, lifestyle, comorbid conditions, and individual preferences. The beta-blocker propranolol also is FDA-approved as a preventive agent for migraines. Long-acting oral propranolol (Inderal), for example, is very useful in combination with the tricyclic antidepressant amitriptyline. Dosage begins with the long-acting agent given at 60 mg per day, and usually is kept between 60 and 120 mg per day. Lower doses, such as 20 mg twice per day of propranolol, sometimes are effective. Other b-blockers, such as metoprolol (Toprol XL) and atenolol, also are effective. Some of these are easier to work with than propranolol because they are scored tablets, and metoprolol and atenolol have fewer respiratory effects. Beta-blockers are useful for migraine patients with concurrent hypertension, tachycardia, mitral valve prolapse, and panic/anxiety disorders.

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    Propranolol for migraine prophylaxis. Linde K1, Rossnagel K. Author information 1Centre for Complementary Medicine Research, Department of Internal. Propranolol is lipophilic, crosses the blood brain barrier and has actions at adrenergicIn 2004, Topiramate was licensed in Ireland for migraine prophylaxis in adults unresponsive to or intolerant. Prophylactic treatment constitutes an important aspect of migraine management and includes avoidance of trigger factors and life style advice followed by consideration of medications.

    Sufficient evidence and consensus exist to recommend propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate as first-line agents for migraine prevention. There is fair evidence of effectiveness with gabapentin and naproxen sodium. Botulinum toxin also has demonstrated fair effectiveness, but further studies are needed to define its role in migraine prevention. Limited evidence is available to support the use of candesartan, lisinopril, atenolol, metoprolol, nadolol, fluoxetine, magnesium, vitamin B (riboflavin), coenzyme Q10, and hormone therapy in migraine prevention. Data and expert opinion are mixed regarding some agents, such as verapamil and feverfew; these can be considered in migraine prevention when other medications cannot be used. Evidence supports the use of timed-release dihydroergotamine mesylate, but patients should be monitored closely for adverse effects. 2 Preventive therapy, which can reduce the frequency of migraines by 50 percent or more, is used by less than one half of persons with migraine headache.3Following appropriate management of acute migraine, patients should be evaluated for initiation of preventive therapy. According to the American Academy of Neurology, propranolol (a high blood pressure medication) is considered a "level A" drug, which means it is effective and should be offered by headache specialists to their patients for migraine prevention. While the "how" behind propranolol's role in migraine prevention is largely unclear, experts speculate that as a beta-blocker, propranolol blocks adrenaline (your flight or fight hormone) from binding to blood vessels surrounding the brain. In essence, this relaxes the blood vessels, theoretically thwarting a migraine attack. Keep in mind, though, research suggests that propranolol only works for some people—it's not a magic cure and thus, requires a trial and error process, which can be tedious, but worthwhile for some. Propranolol, known by the brand names Inderal and Inno Pran in the United States, is approved by the Food and Drug Administration for preventing migraines and treating high blood pressure and essential tremor, among other conditions. Propranolol is available as an immediate-release tablet or an extended release capsule. The immediate release tablet should be taken on an empty stomach while the extended release capsule can be taken with or without food (but should be done consistently).

    Propranolol migraine prophylaxis

    Migraine Prophylaxis - GPSC, Migraine Prophylaxis - Migraine

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    The studies show that sixty to seventy percent of all migraine subjects. of action of propranolol in the prophylactic treatment of migraine are listed below. Migraine prophylaxis goal is a reduction of severity and frequency of migraine attacks as well asPropranolol belongs to the group of beta-blockers. This group of medications is intended for heart. Request PDF on ResearchGate Topiramate and Propranolol for Prophylaxis of MigraineConclusions Topiramate is more effective than propranolol for pediatric migraine prophylaxis.

     
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