Migraines: Propranolol

Part three of the continuing series on living a healthy life with migraines.

Oh Propranolol.  How I love thee.

Often called by the brand name, Inderal, propranolol is a beta-blocker that is often used as a migraine prophylactic.

I’ve talked a lot about my migraines here, but haven’t yet discussed the treatments I’ve tried.  When I first went to the neurologist I was getting 3 or 4 migraines a week.  Some triggers I could avoid, but every time there was a thunderstorm I was hit.  It was ridiculous and he felt it was time to bring in the big dogs and start a daily, preventive medication.

We discussed each of the options available to me, in detail, until we narrowed it down to what we felt was the best choice.  I cannot stress enough how important it is to find a doctor who will not only take the time to talk with you about your options, but also will take the time to listen to you about your concerns.  My general practitioner, who is wonderful in many areas, was convinced that a certain prophylactic would do wonders for me.  However, after taking the time to talk to me about my lifestyle and job, my original neurologist (and my new neurologist as well) strongly advised that we NOT use that medication unless absolutely necessary.

I have been taking 80 mg of extended release propranolol daily for almost a year now, and it has made a world of difference in the frequency of my migraines, but not without side effects.  The highlights of my experience:

  • It works well for me… for most migraines.  Propranolol stopped the migraines from most of my environmental triggers, including all of my food triggers.  However, I still get a migraine on the first day of my period and whenever I exercise.  I can control those two triggers and prepare for them accordingly, so this works for me.
  • The adjustment period was difficult.  I was extremely tired and barely had energy to get through the day.  Thank goodness I have a flexible job and an understanding advisor, because otherwise, I might have been fired.  My arms and legs would fall asleep very easily if they were crossed.  Luckily, after about a month of pushing through, these symptoms went away.  I also still got a few migraines during the first couple of weeks, but they dwindled down in frequency.  Talk with your doctor about what side effects should go away over time and which ones are likely long-term.  It is important to know when to push through and not give up and when to say, this isn’t going to work for me ever.
  • Taking it every day is important.  If I forget to take it, I can get a migraine, and it also messes with my blood pressure.  I am terrible about remembering, so I have to put an item on my calendar to remind me.
  • I’m much more sensitive to temperature changes.  I used to love very hot weather, but I’ve been much less tolerant of temperature extremes since getting on the medication.  In the extreme heat of this summer, my blood pressure dropped dangerously low during those days when it reached over 100 degrees.  I almost fainted a few times and had difficulty forcing myself to eat.  Winter was also hard.  My fingers and toes will also turn blue sometimes if the air conditioning is set too low.
  • I still get migraines from my triggers… they just don’t hurt.  I can tell when I would normally be getting a migraine, but it doesn’t hurt and I’m not sensitive to light or noise.  It is hard to describe.
  • It is cheap, compared to other medications.  Because a generic version is available, I can get a months supply of medication for only $5.  Many of the other medication options were much more expensive.
  • Bonus:  I’m much more calm.  My dosage of beta blockers is often given to people with anxiety to take before giving talks or going into other stressful social situations.  I definitely feel that it has helped me stay calm in those situations, and it also improved my air usage while scuba diving (I used to be an air hog… I always thought I was calm before, but I guess not).

For me, propranolol has given me the ability to live my life and do my work and with minimal side effects.  I am not sure exactly how it works, but I am happy that it works as much as it does.  My husband does worry about the effect it might be having on my heart in the long run, and while that is something I care about, it is something I’m choosing to monitor at this time in favor of not having tons of migraines.  For me, at this time, this is the best option for controlling my migraines and reducing the pain and suffering I was going through on a near daily basis.  I was nervous about taking a daily medication and thought that alone made me a bit unhealthy.  However, now I know that this medication has allowed me to lead a better life on a day to day basis.  I am lucky to have doctors who are willing to talk with me and figure out what I need to live my life the way I want to.  I am currently working with my new neurologist to adjust the time of day that I take the medication to try to reduce the few side effects I have even more.

Have you tried a daily medication for your migraines?  Did it work, or were the side effects too much to handle?

Missed a previous part?

Migraines:  General

Migraines:  Over the Counter

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