#MigraineComorbidity: Living with Multiple Conditions

Lately, I’ve been collecting diagnoses: migraine-associated vertigo, panic disorder, MTHFR deficiency, PTSD, IBS, seropositive RA … The list just keeps growing. Migraine, it seems, is a disease that gets along well with others — or at least enjoys bringing them along for the ride. (I, for one, would be happy to let a couple of these guys off at the next stop, but no one’s asking me.)

Anyone living for long with chronic migraine knows that comorbidities occur frequently. However, I was surprised to learn — until I started my own personal collection — just how many there are. For instance, while I knew that migraine with aura was associated with vertigo, MTHFR deficiency, anxiety, and PTSD, I had less knowledge of the link between migraine and IBS and no knowledge at all of the link between migraine and Rheumatoid Arthritis. While knowing about something doesn’t necessarily change the prevalence of it, I think it would have helped to be prepared.

Juggling multiple conditions isn’t easy, especially when the medications used to treat one disease (e.g. RA) tend to exacerbate another (e.g. migraine). Doing so while working, raising a family, and nurturing a strong marriage is even harder. But I’m not one to let the difficulty of a task faze me.

I started my migraine journey with the determination to figure out how to live the best, most joyful life possible, and I have no intention of stopping now. The journey may be a little rockier, and slightly more precarious, than I had anticipated, but it is the journey I’m on. I fully intend to find the magic moments and silver linings, and I’ll continue to write and share about my progress (the good and the bad) as I go.

Chasing sunshine

 

Propranolol for #Migraine and #Anxiety: The Good, The Bad, and the Ugly

About nine months ago, my psychiatrist put me on the drug Propranolol for anxiety. Propranolol is a beta-blocker drug primarily used to treat high blood pressure, chest pain, and other circulatory disorders. It’s also often used off label for the treatment of anxiety and for migraine prevention. So I figured, why not? If it could treat both my conditions at once, I’d give it a definite try.

But I did have questions:

  1. Would it work for my migraine disease when the other beta-blockers I’d been given for migraine prevention did absolutely nothing?
  2. Would it be safe to take when my normal blood pressure is already so low?

The answers, it turned out, were yes and yes, but not really.

The Good News: 10 mg of Propranolol three times a day did more to manage my general anxiety than any other drug I’ve ever tried except Klonopin, Xanax, and Valium, which are truly more effective for my panic attacks than my overall anxiety anyway. It also had a positive impact, albeit it a slight one, on the frequency and severity of the head pain that accompanies my migraine attacks.

The Bad News: If I skipped a dose, I felt it. Almost immediately. And it was not pleasant. Shaky hands, racing heart, queasiness, and a general feeling of something being not right that quickly transformed into a panic attack if I didn’t get that dose quickly.

The Ugly: While it did seem to reduce the symptom of head pain associated with my migraine attacks, after about three months, it increased my migraine-associated vertigo to such a degree I eventually had to stop taking it. (You can read about my level of disability from vertigo in one of my posts for Migraine.com: “Waiting for My Sea Legs: A Story of Vestibular Migraine.”) I tried to hang on to see if that symptom would eventually disappear, but after months of barely being able to walk, I had to say enough was enough. I did try experimenting, with my doctor’s approval, with decreasing my dose and then the dosing frequency, but that only gave me more of the withdrawal symptoms described above.

I imagine that someone with comorbid anxiety and migraine disease who either doesn’t have low blood pressure or doesn’t live with severe vertigo may have a much better experience with this drug than I did. My migraine disease is so complicated, with its crazy auras and brainstem symptoms, that it’s been impossible so far to find a medication that treats one aspect of the disease without worsening another. That may not be the case for others.

I’m curious: Have any of you readers tried Propranolol for migraine or anxiety? What was your experience?