Introduction
The searing pain of a migraine headache descends on you
while you are at work. The pain is so excruciating that you can’t function, and
you need to go home. This is the third time this month this has happened, and
you are worried about how this is going to affect your job. A coworker tells
you about a drug called propranolol. She says it works great for her, but you
are leery of drugs and need to know more. What is propranolol, and how does it
help migraine headaches?
Migraine Headaches; Causes, other symptoms, and treatment |
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Migraine Headaches
Migraines are the second most common type of headache in the
United States. In 2009 the Centers for Disease Control and Prevention reported
that 10% of men and nearly 22% of women suffer from migraines or severe
headaches. Of those roughly 38% fit the criteria for preventive therapy, but
less than 13% actually use it.
The pain of a migraine usually begins gradually and can last
hours. Often light or physical activity worsen the pain, and many people seek
relief by lying down in a dark quiet room. Other common symptoms that may
accompany a migraine are nausea, vomiting and sensitivity to light and noise.
Migraines can be triggered by many things, including stress,
menstrual periods, lack of sleep, hunger and certain foods.
Propranolol
Propranolol prevents migraine headaches. It is a
beta-blocker, and beta-blockers have been shown to be reduce the frequency of
migraines in 60% to 80% of people who use them.
Propranolol was originally used to treat high blood
pressure. Of all the beta-blockers, propranolol has proven to be one of the
most effective at preventing migraines.
Although there are other medications used to prevent
migraine headaches, propranolol is a good choice for people who have high blood
pressure, heart disease or anxiety.
Dosage
The dosage that has been shown to be most effective is
between 120 mg to 240 mg. Your doctor may start you off with 80 mg daily and
monitor how well that works. Most likely your dose will be gradually increased
until you have a satisfactory response.
Propranolol comes in two formulations, a short acting tablet
and an extended-release capsule. The daily dose does not differ between the
two, but with the extended-release formulation you will need to take fewer
capsules.
Precautions
Propranolol is not without risk. Many people cannot tolerate
it and end up switching to another drug. It can also mask the signs of
hypoglycemia and should be used with caution in diabetics.
In some people with asthma, the use of beta-blockers can
initiate an asthma attack. In general, those with asthma should not use
propranolol.
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Adverse Effects
The most common adverse effects reported with propranolol
include fatigue, depression, nausea and insomnia In men it may cause impotence.
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