What is it?
Propranolol is a commonly prescribed beta-blocker. Beta-blockers are a class of medication that help to reduce blood pressure. They work by suppressing the effects of the hormone epinephrine, effectively damping down the adrenal response.
What are its uses?
Besides its use for migraines, propranolol is prescribed to treat high blood pressure, chest pain, and other heart and circulatory diseases. It can also be prescribed for the prevention of heart attack.
How does it help with migraines?
Increasingly migraine research is pointing toward neuro-chemical explanations for migraines and away from purely vascular explanation. Propranolol, while having an impact on the vascular system, does so by making changes to neuro-chemical pathways related to norepinephrine. The result of these effects are a reduction in neuronal excitability among other changes. Propranolol also has some chemical properties that improve its uptake in to the brain.
When administered prophylactically to treat migraines propranolol is often given at the low end of the dosing schedule. This generally reduces the side effects without impacting the effectiveness on migraines.
How effective is it for migraines?
Propranolol has been shown in studies to be highly effective in reducing migraine frequency and severity. It also has relatively minimal side effects for most patients compared to some other prophylactic options (eg: Topirimate). Additionally, propranolol has been shown to retain its effectiveness at fairly low doses.
What are the common side effects?
Since propranolol affects your blood pressure many side effects relate to that. Specifically:
- Dizziness or light-headedness
- Tiredness
- Upset stomach
- Difficulty sleeping
- Skin irritation
- Cold sensation in extremities
When used to treat migraines propranolol is usually prescribed in lower doses so side effects are generally minimal. In general if you experience any unexpected symptoms while taking propranolol you should consult a medical professional immediately.
Patients are advised to not stop propranolol suddenly, especially at higher doses as it risks chest pains or heart attacks.
When should you avoid it?
If you have low blood pressure or are taking other medication for the management of your blood pressure. Propranolol should be avoided with patients who are allergic or suffer from asthma. It is also not recommended if you are pregnant or nursing.
Always disclose your full medical history with your doctor, including mental health history, when discussing long-term treatments like this to avoid poor reactions or negative side effects.