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

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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?

Melatonin for #Migraine Prevention

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I was finally reviewing my backlogged RSS feeds this afternoon (after months and months of being too tired to even glance at them), and I came across a wonderful post by Diana Lee on Migraine.com about melatonin and migraines. It seems a study released in 2004 and discussed at the American Academy of Neurology (AAN) 65th Annual Meeting in 2012 indicates that taking 3 mg of fast-acting melatonin between 10 and 11 every night significantly reduces migraine frequency with little to no side effects.

As someone who is always looking for scientifically sound natural remedies and supplements for migraine treatment and prevention, I think this is terrific news.

I currently take magnesium, B-2, and CoQ10 supplements for migraine, and I would certainly be open to adding melatonin to this list. (I have a call in to my pediatrician to find out if it is okay to take while nursing. Online facts were inclusive.) Until then, I’d like to hear from all of you.

Have you tried melatonin for migraine or would you be willing to try it based on the study?

It Can’t Hurt to be Prepared

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My son will be born sometime in the next seven weeks, and I’m anxiously attempting to get everything ready. My husband, bless him, has dealt well with a wife whose ideas of preparation include making and freezing soups (two months in advance); stocking up on toilet paper, Ziploc bags, shampoo, laundry detergent, and stamps (two months in advance); and purchasing Vaseline and infant Tylenol (also two months in advance). I’ve seen a few eye rolls, and I did have to explain why I felt it was necessary to purchase the infant car seat/stroller system and the wearable infant carrier at 32 weeks, but overall I think he sees my preoccupation with preparation as a benign symptom of the eighth month of pregnancy. For me, however, it is something much more.

Based on my pregnancy, labor, and delivery 10 years ago, I already know that I have to have a c-section this time around. As a second timer, I’m not too worried about the surgery itself. However, I am very aware of the limitations it will place on me afterward: I cannot climb up or down stairs for two to three weeks (which will be difficult seeing as we live on the third floor); I am not supposed to do housework for at least four weeks; I cannot drive for six weeks; and I’m not supposed to lift anything heavier than my baby or begin exercising for up to eight weeks after delivery. For me, this basically means I’ll be living on my couch for the first four to six weeks with an infant attached to my breast.

I also have migraines, and those migraines often affect my energy levels, my speech patterns, my vision, my concentration levels, and my ability to handle light and noise. They often come on quickly, ramping up to excruciating and debilitating within as little as 20 minutes, and they’re most frequently triggered by lack of sleep, changes in eating schedule, lack of exercise, stress,  dehydration, and hormonal changes – all commonly experienced by the mothers of newborns.

Taken together, these two things (the impending c-section and the ever-present threat of migraine) mean I absolutely must be prepared for my return home before we’ve ever even left for the hospital. The more plans and preparations I can make now, the less I’ll have to worry about or tend to when we get home. Granted, if everything goes according to plan, I still have seven more weeks to wrap up any last minute food prep and laundry tasks, but – as many of us know – things rarely go according to plan, especially when infants or migraines are involved. Adding them together seems to ensure a chaotic start.

I can only hope my relentless drive to prepare helps in the months ahead. I’d hate to spend the first couple of months of my son’s life curled up in pain, unable to soothe his cries because they hurt my head too much. Just in case, though, I’ve decided I’m going to start experimenting to figure out which earplugs block the most noise. We’ll call it one final pre-baby preparation.

Soon-to-be Nursing Mama’s Migraine Toolkit Wish List

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As I lay on my bed last night, suffering with a level eight migraine and wanting to throw my head against a wall, I realized something important: my migraine toolkit is going to need a serious upgrade to go with the new baby.

I plan to nurse, which means almost all of the medications that are off limits now will continue to be off limits for the near future. Additionally, however, my essential migraine prevention plan (which includes getting up and going to bed near the same time every day, eating on a regular schedule, and exercising daily) will be largely irrelevant. I will not be able to tell a new baby that he or she needs to stay in bed a little longer or learn to sleep through the night because otherwise Mama gets a migraine. Nor will I be able to curl up in a dark room when he or she needs to nurse or be changed, or even just wants to play. In short, the life I’ve set up to deal with my chronic migraines is going to be sacrificed for the sake of life with a new baby, which means I’m going to need a new set of tools to deal with the many, many migraines that I’m sure to experience over that first year.

While it may not be common (or accepted) to add a plethora of migraine-relief tools to a baby registry, I’ve decided I should go ahead and make up my “nursing mama’s migraine toolkit wish list.” So, here it is:

1) SootheAway Device, with Front & Side Head Pad, Occipital Relief Pad, and Eye Relief Pad;

2) A freezer full of nutritious frozen meals (for the days I just can’t get up to cook);

3) Bimonthly cleaning help;

4) Comfortable noise-reduction earphones.

That’s all I can think of for now. Does anyone else have any non-drug treatment ideas to share? I keep imagining trying to hold and soothe a crying baby while experiencing the kind of migraine pain I had last night, and I have to say it scares me. Any help would be appreciated.

Update: Magnesium and Coenzyme Q-10 for Migraine Prevention

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I started a new treatment regimen several months back, and recently realized (thanks to several readers’ emails) that I neglected to update the blog with my experiences. So, here goes:

In February, I began taking magnesium and coenzyme Q-10 supplements for migraine prevention/relief. In addition to my standard multi-vitamin (which includes 200 mg of magnesium), I take 100 mg of CoQ10 three times per day, and 250 mg of magnesium once per day. (The recommended dosage in “The Migraine Brain” was 400 mg of magnesium daily, but I was unable to find 100 mg tablets.) I also recently added a 100 mg B2 supplement.

So far, I haven’t experienced any reduction in the frequency of my migraine attacks, but I have noticed a decline in the pain associated with my attacks. What used to be a standard 5 to 7, is now a 3 or 4 on a normal day. Some days are worse, of course, and I still get my sharp stabs of intense (7 to 9) pain, but the overall pain levels are down. This is good news.

As a chronic migraineur, I’ll take what help I can get, where I can get it. If I’m going to keep getting the attacks, at least they’re less painful. And, all in all, this is pretty much the same improvement I experienced on Topamax – without the mood changes, weight loss, and forgetfulness.

I’m interested to learn what the rest of you have experienced. Have you taken magnesium or coenzyme Q-10 for migraine prevention? What happened?