Propranolol and amitriptylene preventives for migraines

[Happydaze2]

After years of struggling and resisting taking a preventative medication for my migraines, GP I spoke to on Friday is keen for me to try and I’m seeing them tomorrow to discuss further; meanwhile I’m doing some research into all the different types and their pros and cons. Propranolol seems the most common - GP mentioned this and amytriptyline specifically as options - and whilst I am aware of both these for other health conditions, I don’t know anyone who has taken either of them for migraine. If you have experience of either I’d really appreciate hearing your thoughts.

My DD felt very ill on propranolol plus had palpitations and her eyelashes fell out.

She's had pzotifen prescribed at three different times, and each time it has helped stop her migraines.

I take both of them, Propanalol 40mg three times every day and amitriptyline 20mg every evening. Works well.

Err well I've taken just about every preventative going for migraine. They all have there plus and negative and everyone reacts differently.

Propranolol worked well for me for a number of years, but I had to keep increasing the dose. This is quite common with migraine prevenatives, the biggest negative I had with it was as it lowers your metabolic rate I put on weight and couldn't exercise effectively as my heart rate wouldn't go up. But that was possibly due to me having to take a really high dose, most people don't take such a high dose as I did.

Amitriptiline I couldn't tolerate as it's an old class antidepressant and made me feel very flat and totally wiped out I couldn't function. There is an alternative that my neurologist tried me on that most people tolerate better and certainly the side effects where better which is nortriptyline. But that one didn't work for me, but a lot of people find it helpful and I'd recommend it over Amitriptiline.

There are a lot of others but your best to try these first. If your on Facebook there is a good support group. Chronic Migraine Awareness UK& ROI you will find a lot of help and support on there.

I take 30mg of Amitriptyline at night for migraine. It makes me feel more tired in general, especially when waking up in a morning, I also find I put on weight so have to really watch what I'm eating and make sure I'm exercising. I find it reduces the frequency of my migraines by about 50%.

Oh and this, I think a lot of people think that taking a preventative will stop there migraine. But most doctors and neurologist only ever expect at beat a 50% reduction in migraine frequency. Yes some lucky people respond better then this (they are classed as supper responders as my headache nurse says). But it's actually not normally the case.

I am prescribed topirimate for mine ( by my neurologist) this is also for the excess CFS / pressure in my brain.

I've been using 20mg amitriptyline daily along with 100mh summatriptin for attacks successfully for several years now and down to around 1 migraine a week from 3 days long cluster migraines once a week. The tiredness takes some getting used to and you will learn how early you need to take it depending on what time you need to function in a morning, but as lack of sleep is a big migraine trigger for me the sedative side is a real help.

I've tried propranolol but suffered from awful night terrors as a result and didn't find it all that effective.

I took amitriptyline years ago and for the first few weeks it just completely wiped me out, slept so much and was exhausted all day. Managed at the time but I couldn't function on medication like that these days.
I had to go on a preventative though because I was taking an extremely high amount of sumatriptan, that should never have been prescribed at such a high/frequent rate and wasn't picked up by a doctor until a whole year after the constant repeat prescriptions, and they basically said they wouldn't prescribe that anymore so I had to try a preventative.
I didn't want to continue prescriptive medications for migraines so I had to do a big overhaul and figure out & eliminate my triggers.
From having chronic migraines daily for years, I now usually only get them when I'm due on or just start my period. Unfortunately you can't eliminate hormonal migraines. But migraines triggered by anything else can be eliminated over time.
I now don't ever take prescriptive meds and haven't in years. The only thing I take when I feel a migraine coming on is aspirin, which for me works wonders if I take it early enough when early signs show and before it turns into a full blown migraine.
Some things I've done that have gradually helped prevent migraines over the years is:
-Daith piercings in both ears (it's an acupuncture point for migraines).
-Wear blue light blocking glasses anytime I'm looking at phone/laptop/tv screens and night driving as LED headlights affect my eyes also.
-Turn brightness down on all screens.
-Regular break from work computer (5 mins every hour or so).
-Don't skip meals as that's a trigger for me.
-Work on regular sleep, as disturbed sleep is also a trigger. Naps can be an issue too.
-Avoid certain alcohol/fizzy drinks. Red wine and drinks with aspartame don't agree with me.
The thing that helped me the most out of all those was the Daith piercings in both ears and blue light blocking glasses, both literally changed my quality of life! And now even when I do get migraines, they're never as severe as they used to be years ago and I noticed that change after the piercings.
It's worth looking into vitamins that can help too, such as magnesium.
Something else I think helped me but may not be for everyone, is meditating/visualising on healing my head.
Medication should always be a temporary assistance, so it's important to figure out what your triggers are and work on gradually eliminating them.
Hope you finally can get to the point where your migraines are not dominating your life.

Propanalol did absolutely nothing for me, but is very effective in a lot of people.

Amitryptiline didn't work because I couldn't get past the side effects of sedation - even taking a tiny dose and early in the evening saw me totally unfit to drive the next morning, you'd have thought I was drunk or high. I lasted only a fortnight on that.

Pizotifen was very effective, and I had it three times for a year each time before being weaned off. The third time it didn't really work at all though.

Topiramate was hell on earth, but again is very effective in a lot of people. I quickly had to titrate up the dosage to maintain the effects, but by the time I was on the max daily dose I was completely doped and it nearly cost me my career and my marriage. Never again. I was an absolute zombie and it wasn't effective enough as I was still having 20+ attacks a month.

I'm now under neurology and on CGRP injections. Botox was good for a while but stopped being as effective. The CGRPs are consistently good for me, but the annual forced 3 month stoppage is just fucking evil and it stopped Ajovy working the next time. I'm on Aimovig now but again, it is nowhere near as effective after the last break because they fucked it up and I was off the jabs for 7 months from absolute hell.

God I hate migraine so much.

Anyway, get on the meds, give them a go, there are plenty of options now which didn't exist even a couple of years ago.

Propanolol is working for me. I have 80mg in the morning and 40mg at night. Side effects were rough for the first two weeks but nothing now. I'm on a diet and am losing weight. I was worried it would be harder to shift the weight while on the medication but so far so good.

@CC222 do you also tell diabetics "Medication should always be a temporary assistance, so it's important to figure out what your triggers are and work on gradually eliminating them."?

I'm glad you're down to hormonal only migraines, but actually there are options for you, but they are prescription triptans.

I have spent most of my life with migraine, triggers are not a simple thing and many of us don't actually have any. It's a fallacy to suggest migraine is wholly preventable with diet or lifestyle changes as you are literally experiencing.

Migraine is a complex disease of the brain. It is not curable.

Migraine can be controlled - or at least the impact reduced - with medication. Telling people not to take medication that can literally save their lives (I was suicidal) and suggesting people should be able to fix themselves is dangerous rhetoric. Drives me crazy.

@ButtSurgery Maybe I worded that part wrong. What I was thinking when I said that, is that from my experience migraine medication came with awful side effects, that were as debilitating as the migraines itself so I looked into anything and everything possible that could help my migraines so I could stop all prescriptive medication.
For many, migraines are caused by triggers which is why GP's recommend keeping a diary when you first approach them for issues with migraines.
Everyone's experience with migraines/medication is different and I wasn't trying to be insensitive or downplaying anyone else's experience, as I know full well how life crushing chronic migraines are.
As I said, everyone's experience is different and I was just sharing mine in case there was something there that may help OP on her journey. Not everything works for everyone, but for many there are ways you can help yourself in the long term outside of medication, however I'm aware that for many, medication is the only course of action to assist.

I’ve been taking propranolol for migraines for about 6 years- it’s changed my life. I’ve taken different dosages throughout this time and am currently on 80mg in the evening. The only side effect for me is that I used to run very hot and now I need gloves in the winter, so probably really another plus. It’s interesting to read that others find losing weight tricky whilst on it as I have found that I can’t lose weight as easily as I used to but hadn’t put 2+2 together.

Started taking 10mg amitriptyline two months ago and I've not had any side effects. Still getting the occasional migraine but far fewer than before.

Thank you for all your comments and I’m so sorry if my post has caused any upset - absolutely not my intention. FYI I’ve been on triptans for several years, taking painkillers alongside, and I am nowhere near as badly affected as many people, in that I’m totally floored by migraine maybe twice a month, for up to 4 days at a time. I am within safe limits of consumption of all medications, but in the last year I have missed out on so much that my mental health is suffering. You will know what it’s like to be unable to plan or commit to or look forward to anything - it’s miserable. I think GP has picked up on the fact the migraines have become more intense and longer-lasting lately and that’s behind their suggestion to try a preventive - but I am not keen on taking something new on a daily basis that potentially has some nasty side effects. Really don’t know what to do

@Happydaze2 Take the preventatives. Migraine is absolutely miserable and you don't have to live like this. If you don't get on with the meds, you just stop taking them (with GP support if you need to reduce first!).

I was given amitriptyline for migraines, ended up in a&e with the worst pain you can ever imagine (I say this after a labour where I nearly died), it felt like someone simultaneously going at my brain with an ice pick through my eye and crushing my skull, I collapsed twice. It happened within hours of taking it, so at least I guess you'll know if it agrees with you or not pretty quickly. Is advise not being alone when you first take it

amitriptyline did zilch for me.

I've taken propranolol for about 2 yrs. It's a very safe medication.

Unfortunately I still get a lot and I'm not looking at medical botox.

I think it depends on your triggers it's usually a lot of trial and error

Neither helped me and propranolol made me faint. I have also tried topirimate and found it mildly effective but with horrible side effects.
The things that have massively reduced migraine volume have been heavy weightlifting which has massively strengthened my neck/shoulders/back, yoga and running (which used to be a migraine trigger until the weightlifting). I notice that if I don't do these things for over a week the migraine levels creep back up. If I am consistent with this and keep hydrated and fed then I am down to as little as 1-2 a month from having migraine or rebound headaches 80% of the time.

Propranolol was a life changer for me, I just wish it had been offered years earlier.

I took 80mg once a day and then 100mg Sumatriptan if I had a migraine.
The one good thing to come out of menopause is a decrease in migraine. I was weaned off the propranolol and now take a 20mg nasal Sumatriptan.

While I agree that finding triggers and eliminating them etc is helpful. What is not helpful is saying that medication should always be a temporary solution. Without my medication, preventative and otherwise, I wouldn’t still be here.
yes, hormones trigger mine, so do certain food/drink/smells/lights/environmental factors that I try my hardest to avoid. But some triggers I cannot pinpoint. I’m currently in bed on day 6 of a migraine. I can take no more of my triptans, I can take no more OTC meds, as there is a limit, my gel eye mask has just burst, the other isn’t cold enough yet, I have hardly eaten all week, tbh I could quite happily die right now because of the pain, and seeing no end in sight. And this is me with 2 lots of preventative medications, Botox and doing all I can to reduce them. They just happen. I’m glad you found what works for you, but knowing how life crushing migraine is, maybe don’t be so dismissive of your fellow migraineurs.

To answer OP ( I apologise) I take propanlol, morning and night, and topiramate morning and night. I have flavotriptan to take when it starts. But it’s hit and miss.
amityptaline was horrific. It turned me into a zombie. having had migraines for 40 years (I’m 44) I’ve literally tried everything. It’s all trial and error to find what works for you.
good luck.

I was on propranolol for migraine for about a year, it did work but I disliked taking preventative medication. Turns out my migraines were caused by my contraception (marina coil) and I haven't had any while being pregnant/ being postpartum (4 months) yet and contraception free.

I did take amitriptiline for sleep when I was about 17/18. It was only about 20mg but made me feel very flat and u had an incredibly dry mouth.

Amitriptyline works best for me

My daughter was put in amiltriptylene at age 13 for migraines. It didn't help but understand it does help others.

After awhile, amitriptyline gave me palpitations and an increased heart rate so I had to come off it. It did work though!

Now on candesartan. Doesn't seem as effective as the amitriptyline but I am not having significant issues with side effects.