Beta blockers for migraines
introduction
A further area of application of the beta-blocker recently is migraine. Here beta blockers are not initially used for the direct acute treatment of migraines, but for prevention. Preventive treatment with beta-blockers should be considered, especially in patients who suffer from severe and regular migraine attacks that recur at regular intervals.
When using beta blockers for the treatment or prophylaxis of migraines, one makes use of the versatile effectiveness and the effectiveness of the beta blockers. On the one hand, these are the effects that are also used to treat high blood pressure and cardiac arrhythmias and relate to the reduction in heart rate. Beta blockers reduce the docking of adrenaline to the receptors by blocking the beta receptors, which are also present on the heart muscle. This lowers the heart rate and also the blood pressure. Migraine sufferers usually complain of severe throbbing pain in the painful nature, mostly one-sided. This pathomechanism has not yet been clearly clarified, but a close relationship between migraine pain and pulse is suspected. The throbbing migraine pain often has a pulse synchronization.
How do beta blockers work for migraines?
The idea behind using the beta blocker is this Heart rate reduction. When the heart beats more slowly, the painful impulses are also “sent” more slowly. Also the Blood pressure has an effect on migraine pain. So introduces strong pain stimulus in the head area even with non-blood pressure patients slight increase in blood pressure (Pain reaction of the body). This in turn leads to a Amplification of pain.
A vicious circle begins. Although the blood pressure in migraineurs is not extremely high and at some point stagnates in its rise, antihypertensive treatment has a positive effect on the pain sensation. Another property of the beta blocker can also be used. Beta blockers also work through the Blockage of receptors on the Stimulus transmission certain annoy a. This is reduced after taking beta blockers. Here you mainly do that Reduced transmission of the pain stimulus advantage.
On the one hand, the reduced effect of adrenaline (through blocked beta receptor) to one decreased pain sensation in the brainOn the other hand, the actual transmission of pain is also slowed down. The pain sensation takes place more slowly, with a delay and is no longer perceived as intensely.
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The side effect of the Beta blockers on the one hand as undesirable and disturbing can also be viewed as part of the actual treatment. This is because beta blockers can, if taken initially, too fatigue and to Reassurance to lead. Patients afflicted with migraine pain often experience this type of pain sedative effect as pleasant and relaxing.
The disadvantage is that Dose-response relationship the beta blocker. Of the body forms Beta receptorswhen the others that are present are regularly blocked. He does this for this reason so that the adrenergic substances can find a receptor and work despite the blockage. The more Receptors replicated be the more less is the beta blocker effect. You have to if this Getting used to it usually occurs dose the beta blocker increase to be able to achieve the same effect. For this reason, the beta-blocker should not be stopped abruptly, as the body would then react with an increased effect. This would most likely be resolved by one fast to racing pulse (so-called tachycardia) and also one Increase in blood pressure to make noticable.
It is also important to pay close attention to how the pulse and blood pressure develop under a beta-receptor blockade. So must be low blood pressure or to low heart rate correspondingly fast counteracted be to a Circulatory instability to avoid.
There are numerous drugsthat to the Beta blockers are counted. Not all of them are used in the treatment of migraines.Despite their common structure, this has mainly to do with the different Bioavailabilities, so that Flooding and Flooding to do. Beta-blockers, such as, are used to treat a migraine, and especially for the prophylaxis of repeated migraine attacks Metoprolol and Propanolol for use. Beta blockers are not used for the acute treatment of migraine attacks. The reason is that the effect of newly set beta blockers only occurs after a few days and for this reason no acute treatment is required. The use of a beta-blocker should be considered, especially if patients have frequent migraine attacks. Above all, this counts very much severe migraine attacks and Migraines, the several times a month occur. In this case you should look for the appropriate neurological evaluation start treatment with metoprolol or propanolol. First of all, a Starting dose of 2.5 mg to get voted. At the Absence of the desired Success But the beta blocker can also to 5 mg be raised. Any setting or adjustment of the beta-blocker should be included closer inspection of Blood pressure and the Heart rate respectively. If a migraine attack occurs despite the use of a beta-blocker, the drug should not be discontinued but should be continued.
Dosage of beta blockers for migraines
The dosage required for beta blockers to prevent migraine attacks depends primarily on which beta blocker is used. In general, a comparatively high dosage is necessary to achieve the desired effect. At the beginning of treatment, however, a gradual increase in the dose is necessary to prevent side effects such as a drop in blood pressure and circulatory disorders.
Each preparation also has a different dose range in which the most suitable dose must be determined individually. For the beta blocker bisoprolol, this is between five and ten milligrams. Metoprolol shows a preventive effect of migraine attacks in the range of 50 to 200 milligrams. For propranolol, studies have shown effectiveness in the range of 40 to 240 milligrams.
Can I take beta blockers even if I have low blood pressure?
Beta blockers are usually one of the drugs of choice for drug prophylaxis against migraine attacks. Another effect of beta blockers, however, is that they lower blood pressure. Therefore, beta blockers are not recommended for patients who already suffer from low blood pressure values or circulatory problems.
There are other alternative medications available to prevent migraine attacks that do not affect blood pressure. In patients with normal blood pressure values, it must be individually considered whether the use of beta blockers is possible and sensible. The doctor will make a recommendation considering all the factors affecting the patient. If necessary, it makes sense to regularly measure and note the blood pressure values at the beginning of a migraine prophylaxis.
Do the beta blockers have any effect on sport?
Beta blockers usually reduce maximum physical performance. Particularly in endurance and strength sports, taking beta blockers for migraines can lead to reduced performance. However, this is perceived differently by everyone. Since endurance sports in particular have a very positive effect on migraines and also prevent attacks, it must therefore be considered individually whether the use of beta blockers is useful or rather a hindrance.
Read more on the subject at: Beta blockers and sport - how do they get along?
Side effects of beta blockers
The possible side effects of beta blockers, which are used to prevent migraine attacks, correspond to the general side effects of this group of drugs.
Due to the antihypertensive effect of beta blockers, there are frequent circulatory problems that can manifest themselves in the form of dizziness or fatigue. Occasionally, blood sugar levels can drop, so that beta blockers shouldn't be used in diabetics who inject insulin. A narrowing of the airways by the beta blockers is rare, but also possible. Patients with asthma or other lung diseases should therefore also not be treated with beta blockers. Side effects such as gastrointestinal complaints are also rare. In men, treatment with beta blockers can rarely lead to erectile dysfunction - usually known as "impotence".
What do I have to consider when stopping?
Beta blockers must always be tapered off, i.e. slowly reduced, when they are stopped. The time required for this varies and depends primarily on the original dose. Often times, the doctor will gradually reduce the dose over about two weeks.
This cautious tapering is very important, as an abrupt interruption of the medication otherwise increases the risk of cardiac arrhythmias or even a heart attack. The reason for this is the so-called rebound effect. Taking beta blockers increases the number of so-called beta receptors throughout the body. Sudden discontinuation of the beta blockers then leads to an excessive response to the stress hormones adrenaline and noradrenaline with the consequences mentioned. Stopping the beta blockers taken preventively can also trigger a migraine attack.
