Low Dose Beta Blockers...help For Migraines?

[LMG]

Well another two days of migraines. I finally have an appointment with neurologist for headaches. I would like to discuss the following treatments with him: Low dose beta, maybe Pamelor (tricyclic AD), botox.

I am on low dose florinef and SSRI and klonopin, none of which have helped or worsened the migraines.

Anyone find any relief with those or something? I am dealing with other POTS symptoms but losing three to four days a week due to the migraines. Can't use triptans as that (zomig) is what triggered the POTS for me last year.

Thanks for any input.

[firewatcher]

I have what my neurologist has diagnosed as transformed/chronic migraine. I've had a headache every day for the last 6+ years. Propranolol did very little for the headache, but Klonopin knocked it down to barely a 1 on the pain scale. It was there if I stopped to feel for it, but it was not the nauseous, throbbing, life-stopper that it had been. I have recently attempted to taper off the Klonopin, but the headache is coming back with a vengeance. I may not make it off that med for long. My GP and I have discussed other options that are not "controlled substances," so I will try them, but I know that Klonopin works.

I have frequently seen recent articles on dopamine and migraines, and have tried to make sense along with dopamine and POTS. I haven't been able to finish my thoughts connecting the two, but I'm working on it. BTW, Klonopin is a dopamine antagonist, as is melatonin. Here is an article that might help you and your doc make better treatment choices:

Cent Nerv Syst Agents Med Chem. 2009 Mar;9(1):63-70.

Neuroleptics and migraine.

Dusitanond P, Young WB.

Source

Jefferson Headache Center, Department of Neurology, Thomas Jefferson University, USA. petcharad@yahoo.com

Abstract

Many dopamine antagonists are proven acute migraine treatments. Genetic studies also imply that polymorphisms in dopamine genes (DRD2 receptors) in persons with migraine may create dopamine hypersensitivity. However, treatment is limited by the adverse event profiles of conventional neuroleptics including extrapyramidal symptoms, anticholinergic and antihistaminergic effects, hyperprolactinemia, and prolonged cardiac QT interval. Atypical neuroleptics cause less extrapyramial symptoms and some atypical neuroleptics, including olanzapine and quetiapine, may be beneficial as both acute and preventive migraine treatment. The combination of prochlorperazine, indomethacin, and caffeine is effective in the treatment of the acute migraine attack. The mechanism of action by which neuroleptics relieve headache is probably related to dopamine D2 receptor antagonist. Other actions via serotonin (5HT) receptor antagonists may also be important, particularly for migraine prevention. Additional studies to clarify the mechanism of action of neuroleptics in migraine could lead to new drugs and better management of migraine. PMID: 20021339 [PubMed - indexed for MEDLINE]

[Katybug]

Prior to POTS, I hadvery good results from Verapimil (calcium channel blocker). Now, my POTS/migraine neuro (yes, I got lucky and have a 2-in-1 with this doc) has me on Depakote with pretty good results. I do still get migraines but not the 3-4 a week I was having. The doc was vey careful to make sure I am not planning on becoming pregnant as Depakote has been associated with birth defects and is not suitable for woman planning on pregnancy.

I am on Metoprolol (beta blocker) and that had absolutely no impact on making my migraines better.

[humbled_pie]

Propranolol (beta blocker) did not help my headaches and made my POTS symptoms worse - only no one realized I had POTS at the time. I haven't tried any other beta blockers.

(I'm really not entirely sure what finally brought relief to my migraines (several a week), but I do think in part it was going on a gluten free diet. If I accidentally have gluten - ever - my body reacts with a killer migraine within 12 hours. Every time I have had a migraine since going gluten free, I have been able to find "hidden gluten" in something I ate within the last day.)

[LMG]

Firewatcher- do you take the klonopin in the day as well as night? I take a night dose but was told by my GP that a 1/4 dose in the day would be ok too. Did you notice the effects right away?

I guess I never explored the gluten aspect. I figured since I am in my 50's i would have known about the gluten.

Thanks for the input.

Anyone try botox? I wonder if it could make the POTS worse. My GP says I will feel worse on the beta blocker. I have low aldosterone.

[angelloz]

I had the botox and couldn't swallow food...SEVERE neck pain, awful..the ER told me not to get it again. I do think my neuro. gave me too high of a dose. I do take triptans when unbearable but they make me feel terrible...rock and a hard place. I too have haedache and pain daily. I took Kepra which I think help but made my muscles feel week. I seem to react to EVERYTHING.

angelloz

[LMG]

I have the head of my bed elevated still from several months ago. I wonder if lowering it would increase blood flow or make things worse? Anyone find that raising head makes headaches worse? Mine start at 6 am always.

Angelloz- that sounds scary and something that could happen anyone. Botox seems scary to me.

I have tried magnesium, shots of magnesium, acupuncture for a long time and not a dent in it. Maybe will try riboflavin or a drug I guess.

[Katybug]

I don't have my bed raised but sleep on several pillows propped up. If I try to sleep flatter, my migraines are actually worse Botox scares me too, that's why I haven't tried it...I ust feel like my immune system is soooo sensitive (I have bad inflammatory issues) that it scares me to think of injecting botulism (even dead cells) into my body. I am afraid of having some type of mmune reaction which is the last thing I need. I really hope you find a treatment that works for your migraines...they are so hard to live with when they are this severe.