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    Suggest treatment for persistent headaches while on Propranolol

Posted on Wed, 2 Aug 2017 in Headache and Migraines
Question: Need to know if propranolol increase (by small amount) will aid in the tachycardia I sometimes get from the Oxycodone I take for dibilitating migraines....
Headaches are a result of 3 fused cervical disc (1 still herniated) after I fell on a metal table in my lab in bact-t... 2008. A lot of spurs and pinching back there when the barometric pressure drops during storm. The mom of XXXXXXX I spent 17 day in bed, EVEN with medication.

I also have Autonomic Neuropathy.... diagnosed after 7 month in 2013 through the table-tilt test. I fainted.


Propranolol, Oxycodone, Cambria powder and gel (couldn't use powder because it was an NSAID... not going there with the propranolol, 100 MG of gabepentin 2x a day, .5 Klonopin 3x a day if needed, 100 MG of Topamax 3x a day, 10 MG of Ambien if needed (small pineal cyst resulting in miniscule amount of melatonin production), tried Melatonin, but had " hangover effect the next day, Amrix for tightened muscle in neck during migraine, and amitriptyli e (sp?) 50 MG at night.

I also developed RSD (or CRIPS) after my neck surgery, had no control over either wrist or hand, doctors looked into was finally diagnosed with RSD at the Emory Clinic. Doctors here first looked into Guillain-Barré Syndrome, parasites, etc. But it ended up being RSD.
So... 2 autoimmune diseases, I'm allergic to sulfur and Tylenol, and I'm a book waiting to happen, lol.
Answered by Dr. Erion Spaho 28 minutes later
Brief Answer:
Please provide the current dose of propranolol.

Detailed Answer:
Hello and thanks for using HealthcareMagic.

I have read your question and understand your concerns.

Tachycardia may result as one of autonomic neuropathy symptoms besides from oxycodone use.

Beta blockers such propranolol are actually used to control tachycardia, however, it is necessary to provide the current dose of propranolol, blood pressure values and heart rate in order to judge better about the benefits of propranolol dose increase.

Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Erion Spaho 1 hour later
I started with metaprolol in the summer of 2013, but I had rerrible sweeping in my calves and ankles. I switched to a different cardiologist in August of 2013, and he put me on the propranolol 20 MG 3x a day. I did a follow up with him every 3 months for a year, because supposedly he was the only one in town who was well versed in this disease/disorder. Unfortunately, my insurance was private (BCBS), and he did not accept it. I was willing to pay the $150.00 out of my own pocket just to see him, but after the first 2 visits I was stuck with his PA... who didn't know a thing about AN or even dystopia. So I just handed it off to my family physician, and if something major pops up, like Gastroparesis, or the first time with the tachycardia, the angina, etc... I just call the XXXXXXX Clinic in Ohio. But it's 5 am right now, and I've never dealt with the neurological aspects. I majored in biology, so I have just enough info to scare mysef. :-)
So, now it is July of 2017, and I am on the same dosage that I was when I started taking it in August of 2013... 20mg 3x per day. My blood pressure is beautiful... it stays at or below 110/80, and my pulse stays around the mid 80s at rest (that is a family thing... we all run a high pulse).
I have spiked as high as 186, but my usual spikes hit around 155-163. Most of these are during a migraine, but every so often one will come out of nowhere... meditation is a great thing until I can remove myself from the situation. I've always had anxiety, but this takes it to a whoLe new level.

So dosage is 20 MG 3x a day
Blood pressure is awesome at 110/80
Pulse stays around the mid 80's, but Tachycardia has taken it to 186... usually just in 150'some
Pulse ox overnight study was 96

I haven't fainted in over a year, but the light headed feelings (like Vertigo) are coming back.
I'm a natural klutz, but I do seem to be tripping up more often.

I'm a 44 year old Caucasian, single mom, with a fairly great attitude. No sense in cringe over something that you can take charge of.
I'm 5'9" tall and weigh about 186... I am losing right now, though.
No alcohol, no drugs, but I do smoke 1/2 pack of cigarettes a day... been cutting back.
My son was In Vitro, and I never liked all the Lupton that went into me...

Thanks for all you are doing. If I don't respond for the next several hours, then I'm probably asleep... finally!!!
Answered by Dr. Erion Spaho 4 hours later
Brief Answer:
The dose of propranolol could be increased.

Detailed Answer:
Welcome back and thanks for the additional information.

Maintenance dose of propranolol is from 80mg to 240 mg daily, so, you are actually below the minimal maintenance dose.

In my opinion, you can add another 20 mg/daily and to see how it is going with the tachycardia.

You can try this new regimen for a couple of weeks.

Of course you should discuss with your Doctor too about these issues.

Hope I helped you.

Kind regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Answered by
Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3856 Questions


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