Migraine anxiety with

A contact dermatitis occurs infrequently. Because feverfew also inhibits human blood platelet aggregation, interactions are possible with antithrombotic medications such as aspirin or warfarin (Groenewegen and Heptinstall 1990). Abrupt discontinuation of feverfew by people taking it chronically for treatment of migraine can produce rebound withdrawal symptoms. These consist of migraines, anxiety, poor sleep patterns, and stiffness of the muscles and joints. 

Substance P, an undecapeptide, is abundant both in the periphery and in the central nervous system. It is usually co-localized with one of the classical neurotransmitters, most commonly serotonin. Substance P is thought to have a role in the regulation of pain, asthma, psoriasis, inflammatory bowel disease and, in the CNS, emesis, migraine, schizophrenia, depression and anxiety. The substance-P-preferring receptor neurokinin-1 has been focused on most intensively in drug development, and existing... 

There are various neurologic disorders which can be treated with jS-blockers like migraine, certain forms of tremor and alcohol withdrawal syndrome. Somatic manifestations of anxiety respond well to /3-adrenoceptor blockade. jS-Blockers with a selectivity for the jSi-subtype might be useful to avoid extracardial side effects. 

Use with caution in oider patients with Cardiovascular disease (CVD), especially angina, arrhythmias, orCHF, Cor Pulmonale, Hepatic dysfunction. Active pepticulcer disease, GERD, /Anxiety, Seizure disorders. Migraine headaches. Hyperthyroidism... 

Unlabeled Uses Relief of neuropathic pain, such as that experienced by patients with diabetic neuropathy or postherpetic neuralgia treatment of anxiety, bulimia nervosa, migraine, nocturnal enuresis, panic disorder, peptic ulcer, phantom limb pain... 

Propranolol reduces the frequency and intensity of migraine headache. Other 13-receptor antagonists with preventive efficacy include metoprolol and probably also atenolol, timolol, and nadolol. The mechanism is not known. Since sympathetic activity may enhance skeletal muscle tremor, it is not surprising that 13 antagonists have been found to reduce certain tremors (see Chapter 28). The somatic manifestations of anxiety may respond dramatically to low doses of propranolol, particularly when taken prophylactically. For example, benefit has been found in musicians with performance anxiety ("stage fright"). Propranolol may contribute to the symptomatic treatment of alcohol withdrawal in some patients. 

In a randomized, double-blind, dose-ranging study in 305 adults receiving droperidol 0.1, 2.75, 5.5, and 8.25 mg for the acute treatment of migraine, the number of patients who achieved a pain-free response at 2 hours after treatment was significantly greater than with placebo for droperidol 2.75, 5.5, and 8.25 mg (8). The most frequent adverse events were akathisia and weakness, and adverse events were dose related. Anorexia, anxiety, somnolence, tremor, and confusion were also reported. No patient had QT interval prolongation. 

The effects of hydroxyzine 50 mg/day, buspirone 20 mg/day, and placebo have been studied in 244 patients with generalized anxiety disorder in a double-bhnd placebo-controlled study (16). Hydroxyzine (n = 81) was considerably better than placebo (n = 81), and buspirone (n = 82) was intermediate. The main adverse effects were headache and migraine with buspirone (6.1 versus 4.9% with hydroxyzine and 1.2% with placebo). Somnolence occurred in 9.9% with hydroxyzine, 4.9% with buspirone, and none with placebo. Dizziness occurred in 6.1% with buspirone, none with hydroxyzine, and 2.5% with placebo. 

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