Calcium channel blockers migraine prophylaxis

Drugs useful in prophylaxis of migraine are P-adrenergic blockers (usually propranolol), methysergide, calcium channel blockers. 

Propranolol, amitriptyline, and some calcium channel blockers have been found to be effective for the prophylaxis of migraine in some patients. They are of no value in the treatment of acute migraine. The anticonvulsants valproic acid and topiramate (see Chapter 24) have... 

A 25-year-old woman with a history of migraine headaches was started on a calcium channel blocker 6 months ago for prophylaxis therapy. She now reveals that she has been having problems with constipation since starting therapy. In addition, she says that her gums are "overgrowing." PMH Depression and diabetes. Which calcium channel blocker is the most likely cause of her side effects ... 

The P-blockers propranolol and timolol are FDA-approved for migraine prophylaxis, but other drugs in the class are also as effective.46 Cautious dosage titration is advised for those patients who do not have other indications for P-blocker use. Rizatriptan interacts with propranolol and thus dosages must be titrated downward, or another triptan chosen for abortive therapy.36 Comorbid reactive airway disease is a relative contraindication to P-blocker prophylaxis, and patients with cardiac conduction disturbances should be closely monitored. Calcium channel antagonists are often used when patients cannot tolerate P-blockers. They are purported to beneficially... 

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