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Beta blockers have been deemed effective options for the prevention of migraines. In particular, metoprolol, timolol and propranolol have the most strength of efficacy. [9] The timeframe to effectiveness in generally within 3 months. [9] Patients with cardiovascular risk factors should avoid the use of beta blockers for migraine prevention. [9]
The most commonly prescribed drugs for migraine prevention are beta-blockers, antidepressants, and anticonvulsants. The drugs are started at a low dose, which is gradually increased until therapeutic effects develop, the ceiling dose for the chosen drug is reached, or side effects become intolerable.
Beta blockers with greater blood–brain barrier permeability can have both neuropsychiatric therapeutic benefits and side effects, as well as adverse cognitive effects. [76] Central nervous system-related side effects and risks of beta blockers may include fatigue , depression , sleep disorders (namely insomnia ) and nightmares , visual ...
Rescue treatment involves acute symptomatic control with medication. [4] Recommendations for rescue therapy of migraine include: (1) migraine-specific agents such as triptans, CGRP antagonists, or ditans for patients with severe headaches or for headaches that respond poorly to analgesics, (2) non-oral (typically nasal or injection) route of administration for patients with vomiting, (3) avoid ...
Other side effects include masking the symptoms of low blood sugar in those with diabetes. [3] Use is not recommended in those with asthma, uncompensated heart failure, or chronic obstructive pulmonary disease (COPD). [3] It is unclear if use during pregnancy is safe for the fetus. [6] Timolol is a non-selective beta blocker. [3]
Atogepant, sold under the brand name Qulipta among others, is a medication used to prevent migraines. [4] [5] It is a gepant, a calcitonin gene-related peptide receptor antagonist administered orally. [4] [7] The most common side effects include nausea, constipation, tiredness, somnolence (sleepiness), decreased appetite, and decreased weight. [5]
Pizotifen is able to dose-dependently and fully antagonize the discriminative stimulus effects of the serotonin–norepinephrine–dopamine releasing agent and serotonin 5-HT 2 receptor agonist MDMA in rodent drug discrimination tests. [10] Conversely, the related drug cyproheptadine was only partially effective and clozapine was ineffective. [10]
Side effects are similar to other triptan medications, with the incidence of side effects reportedly being lower than sumatriptan, and side effects occurring rarely except when above 2.5mg. [ 5 ] [ 6 ] The risk of triptan side effects is also in general low, according to a systematic review. [ 7 ]
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