Beta Blockers And Allergies

[mkoven]

Hi,

I'll talk to my new migraine doc tomorrow, and I imagine we will conclude that I can't continue the nimotop, the calcium channel

blocker because of the raised hr, dropped bp, throat reaction.

The doc had asked me to check with an allergist about beta-blockers and allergies. I had previously been told that bb's were contraindicated in people with serious allergies and a history of anaphylaxis, as they can worsen the reactions and make them harder to treat.

Any input? We're looking for another migraine preventive. She had said she likes inderal or toprol. I see some folks on here who do have bad allergies and take bb's. how has that been?

Then there is the matter that I don't normally have tachycardia-- rarely anything higher than 96 when i'm resting. My big issue is blood pressure drops. Wouldn't bb's make those worse? could toprol or inderal ever help just ncs/nmh? She thought so, but that's not her main area.

thanks1

Michele

[doctorguest]

Allergies is a "relative" contraindication to beta-blockers use, not an absolute. Your allergist would need to determine whether you could still try a beta blocker. Inderal would not be a good choice for those with allergies because it blocks both b1 and b2 adrenergic receptors, and the respiratory system is full of b2 receptors. If you do get permission from your allergist to try a beta blocker, atenolol or metoprolol would be the ones to try. All beta and calcium channel blockers decrease blood pressure, so this is something to watch out for with NCS. There are also other preventative headache medications, besides beta and calcium channel blockers, but I am sure your doctor would discuss these with you when/if you exhaust her first choices. Good luck!

[Sunfish]

hi michele -

i haven't been able to chime in on your other posts, but i was SO happy that your appt with the headache specialist was such a success. and of course sorry that the new med isn't going so well, but glad at least that you have a good doc to work with now in regard to other options as opposed to being left high & dry on your own (as i know you have been at times in the past). but on to the beta blocker & allergy question.....

b/c of how my health has changed (not for the better) i don't take any beta blockers now but did for a few years in the past and sm someone with a good number of allergies, though not as many as you deal with. i've also never had a full anaphylactic rxn, though my former allergist said that based on my allergy testing results he sees it as a very real possibility. most of my allergic reactions are in the realm of sniffles, sneezes, congestion, etc. though some hives/ blistering rashes happen for me with a few things as well. but thus far no life or death allergic reactions (knock on wood). b/c of some IV meds i've been on at home i do have an epi pen on hand. most of my allergies are environmental, though there are a few foods & meds i have problems with as well. and, ironically enough, may be adding something to my list as i've had hives since last night...trying to pinpoint now what may be new that could be contributing but who knows. itchy, itchy, itchy to say the least! but i digress...

my former allergist (who i'd still have if i hadn't moved 500 miles away) was ideal b/c he was pretty well versed in autonomic dysfunction. he'd shared several patients with dr. rowe, a top autonomic specialist (pediatric) in the years prior to my seeing him & had had numerous conversations with dr. rowe, done a lot of reading, etc, so i was very lucky in that regard to have someone who "got it". when i started seeing him i wasn't on a beta blocker. when i was later started on one he was comfortable with it WITH the stipulation that i absolutely could not continue my allergy shots, the reasoning being that if i were to have a systemic/ severe reaction to a shot the BB would hinder their ability to treat me effectively and in turn, particularly in combination with my already having BP/ HR issues, it could be very dangerous. i was on a low dose of inderal (10mg TID). so...extrapolating a bit in regard to my allergists concerns about betas & shots for me i could see that they would be a concern for someone with more of a tendency/ history of severe allergic reactions.

the only time a beta blocker helped me was during the years that tachycardia was a primary issue for me. i had low BP issues then too and could never take a beta without also taking midodrine, but the beta did help me symptomatically a lot during that time. i was taken off of it about a year ago b/c my HR doesn't get as high anymore (aka doesn't bother to compensate) and b/c my BP was consistently too low despite maxing out on midodrine dosing.

when i was first started on a beta many years prior to that, at which time i had an NCS diagnosis and rarely had tachy it was a disaster and left me fainting left & right; that was toprol, though seeing that it was over ten years ago i don't recall the dose.

so...i've had good & bad beta blocker experiences. as a part of the med trial research i was a part of at vanderbilt they seemed to help me but only WITH midodrine. without i was out cold within seconds.

as a sidenote i do get migraines but so intermittently that i only take abortives (not preventives) and can't really comment on whether the betas made any difference when i was taking them.

not sure if any of my ramblings are helpful in the decisions you have to make, info your looking for, etc, but figured i'd chime in with anything that might be slightly relevant.

i hope you're able to figure out something that helps without hurting!!

melissa

[mkoven]

Thanks, you guys!

I'm eager to hear what my other preventive options will be...

i've had allergic reactions in the past to three tricyclic antidepressants (hives). it's been so long, but i believe it was imipramine, desipramine, and a third common one. this was the early 80s before ssris. i don't know if that means i'd likely react to others in that class. i remember that it took at least a week each time, and then i was covered in itchy hives. this happened with effexor too in 2003. not anaphylactic, just hives, but still...

she was reluctant to move to topamax, because of the cognitive side effects. Since my job is all about using words (teaching/writing/reading), she thought I wouldn't tolerate anything that would make it hard to find words. but did say this might end up being an option...

it is good that she said she won't fire me because i'm hard to medicate. i just hope she has a lot of creative tricks up her sleeve.

[goldicedance]

As many of you know, migraines had been a terrible way of life before finding the "recipe" for success...i.e., preventing migraines in the first place. As many doctors now accept, migraines are part of the POTS complex.

Here is what works for me (I now only have a couple of migraines a month and they respond to my first weapon in the aborting migraine arsenal:

150 mg Lyrica twice a day (had been on Neurontin 3600 mg a day)

250 mg Zoloft

When I get a migraine, I find that Maxalt is the drug of choice for me coupled with percocet. I take a maxalt at the first sign of a migraine. If, after 2-3 hours, no relief, then take 2 maxalt. The list goes on...including DHE and finally hospital. The plan takes about 48 hours before giving up and going to the hospital for IV DHE.

My headache specialist thinks that Topamax has more potential side effects than Lyrica and Zoloft.

I assume that you are not taking Florinef. That drug prompted a migraine attack that lasted 7 hospital days. I will never ever take Florinef.

Good luck.