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Verapamil For Migraine

verapamil for migraine

Introduction

Migraine is a common disorder that affects approximately 17 percent of women and 6 percent of men. (See "Pathophysiology, clinical manifestations, and diagnosis of migraine in adults", section on 'Epidemiology'.)

The preventive treatment of episodic migraine headache in adults is reviewed here. The clinical features and management of chronic migraine are discussed separately. (See "Chronic migraine".)

Other aspects of migraine are reviewed elsewhere. (See "Acute treatment of migraine in adults" and "Pathophysiology, clinical manifestations, and diagnosis of migraine in adults".)

What is Verapamil?

Verapamil is a type of medication known as a calcium channel blocker.  It comes under many brand names, such as Calan, Covera-HS and Isoptin.  Because of the calcium blocking function, blood vessels are dilated, reducing blood pressure and the amount of oxygen your heart uses.  It also reduces the risk of spasm in blood vessels.  As you may guess, verapamil is commonly used to treat issues like high blood pressure and some other heart and circulatory related problems.

Who takes Verapamil?

Verapamil actually has become an increasingly common medication for migraine of all classes.  However, there are some conditions it’s more likely to be used:

  • Cluster Headache (both chronic and episodic)
  • Hemiplegic Migraine, including both sporadic hemiplegic migraine and familial hemiplegic migraine
  • Migraineurs who already have high blood pressure
  • Migraineurs who can’t take beta blockers (ie because of asthma)
  • Menstrual Migraine
  • Migraine induced by orgasm or exercise
  • Types of migraine with prolonged aura
  • Verapamil has also been used successfully to treat children and adolescents with migraine.

Side effects

Verapamil is a favourite in the class of calcium channel blockers, partly because it’s less likely to cause side effects.  However, as with any medication, some people do experience some.  Most commonly:

  • Constipation
  • Swelling of the feet, ankles or legs
  • Slowing of the heart rate
  • Tiredness or heaviness
  • Light headedness

There are others, though these tend to be the most common – please talk to your doctor if you notice any side effects.

Preventive medications

Medications can help prevent frequent migraines, with or without aura. Your doctor may recommend preventive medications if you're having frequent, long-lasting or severe headaches that don't respond well to treatment.

After a few weeks of taking them, preventive medications can help you have fewer migraines and help treatments work more effectively when you do have a migraine.

Preventive medication options include:

Blood pressure-lowering medications. These include beta blockers such as propranolol (Inderal LA, Innopran XL, others), metoprolol tartrate (Lopressor) and timolol (Betimol). Calcium channel blockers such as verapamil (Calan, Verelan, others) can be helpful in preventing migraines with aura.

Antidepressants. Amitriptyline, a tricyclic antidepressant, has been found effective in preventing migraines. Because of the side effects of amitriptyline (such as sleepiness, weight gain and more), sometimes other antidepressants are prescribed.

Anti-seizure drugs. Valproate (Depacon) and topiramate (Topamax) may help you have less frequent migraines, but may cause side effects such as dizziness, weight changes, nausea and more.

Botox injections. Injections of onabotulinumtoxinA (Botox) about every 12 weeks can help prevent migraines in some adults.

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