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Information on Beta Blockers
For a long time, Beta Blockers (Inderal, Tenormin, Corgard, Lopressor) have been a mainstay for the prevention of migraine and, to a lesser extent, tension headache. However, because of the propensity of these to cause weight gain (ugh!!), fatigue, increasing a person's asthma or shortness of breath, decreasing
exercise tolerance, memory problems or 'spaciness', and general listlessness, these drugs have receded in popularity. They do remain very useful in many patients. In general, the preventive meds do not work for everyone, and we have not had an influx of newer preventives (unlike the situation with abortive headache stopping medication where many advances are being made).
Inderal (propranolol) is usually dosed at 60 or 80mg of the LA (long acting) version. We will occasionally go up to 120, 160, or higher doses. However, with higher doses, fatigue and decreased exercise tolerance becomes a
problem. At times, we will decrease to small doses, 20mg twice per day or even less. If someone is on a beta blocker for more than a short period of time, it is important to slowly taper, or wean, off of it.This becomes increasingly important as people get older, because just stopping
the drug cold can lead to a fast heartbeat for awhile, which is dangerous with increasing age.
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