Is this as good as it gets with MAV treatment?

So, I’m on beta blockers and a strict trigger free diet. I still have headaches almost every day. On average I might have two or three days a week when I’m not down with a headache to some greatly varying degree. I’ve been on the meds-diet combo since early June and it is now mid-August. My headaches don’t last as long nor are they usually as severe as they were before the regimen.

So, my question is

Is this as good as it gets?

My doc seems to think it might be all I can hope for until my condition changes on its own. :roll: Yikes. Do I ask my GP about different meds? My ENT doc seems to think that bc this is working even a little that I’m doing fine. I am not even supposed to go back to see him for 6 months.

I still get set off by patterns on floors, tight spaces, most commercial buildings, etc… Is this gonna be the norm… for the foreseeable future?

Hey, I think you will continue to get better once you get the Migraines under control you should then start VRT exercises to compensate. Has anyone ever told you that you have vestibular damage? Check out the website and read all the stuff in it. Go to your doctor and tell them you think you have Vestibular damage and need VRT to begin compensation but only after you get the Migraines under control. You need to see a Otologist not an ENT.

Well, I’ve now added Amitryptaline to my beta blocker and feel even better after couple more months have passed by. I’m going to discuss the VRT with my doctor to see what he says. Thanks for the info on the page.

Hi Leslie-

Just a quick question. I’ve been on betablockers for about 8 months with about 60% improvement. I really wasn’t aware that you could take a betablocker along with amitryptaline. (I’ve never pressed the issue with my Doctor, however, I’ve considered amitryptaline to be the next thing to try, except, with the improvement that I have had, I’ve been fairly happy.)

I’m taking 20mg. of inderal (betablocker) in the am, and 40 mg. at night, may I ask the dosages that you are taking, and you are seeing improvement? I can’t really complain, my dizziness comes and goes now, but is much improved, however, I’m wondering if adding amitryptaline may help me even more.

F.Y.I. - the neurologist that orginally prescribed the inderal for my migraines is no longer in the picture. I am just seeing my regular family doctor who now prescribes it. Any insight from you would be greatly appreciated.

20-40mg is a very low dose of propranolol (inderal)

i took it for some time, but it didn’t work for me. i titrated up to 240mg/day

I am on 100 mg of Toprol XL aka metoprolol and then 50 mg of Amitriptyline aka Elevil. I take both at night bc the Ami zonks me out pretty quickly. :slight_smile: Which is good for me bc I used to have a hard time staying asleep all night.

I started out on lower doses of Toprol and then added the Ami and then upped the dosage on both and have built up over time. I have been lucky to experience non of the side-effects except for having a bit of dry mouth… which isn’t that bad for me either bc I drink lots of water now!

I can’t guarantee that this will work for you. Def. talk to your docs about this. Unfortunately this is not a cure-all. It still does not STOP my symptoms. But, it def does. seem to lessen the severity (time spent down in bed dizzy) and it seems that I can tolerate things a bit more than I used to.

I’ve cut out all caffeine and still follow a pretty strict trigger free diet. When my head starts to hurt or I start to feel that sleepy feeling that I get before most of my headaches, I take two tylenol and usually I feel better/can tolerate noise better/light better/riding in a car better, etc.

My doc says that this does combi. doesn’t work for everyone. I was fortunate that the first combination worked for me.

BTW, I visited a new neuro yesterday that my managed care assigners assured me was a MAV expert.

1- He informed me that he really doesn’t believe that MAV is an actual diagnosis.
2- He thinks I have migraine. He thinks I have vertigo. …But, he’s not convinced that they are related. He thinks I just “think they overlap.”


Here is the story as I see it on medications and treatment.

Here is a website that keeps a very current list of medications used to prevent or treat migraine: … e_meds.htm

This is just a list; there are more. And these can be use in many combinations. So there is kind of an endless list of things that can be tried, so whatever you tried so far isn’t the end.

The trouble is that in my experience the docs have one or two pet meds they like to use, and that’s it. They don’t know about all these others. So only a migraine specialist would know about all these, or care, or try them. They are all throwing topamax or neurontin at everyone around here, and nothing else. There are plenty of things with fewer side effects to try first…

So there is more stuff to try. Just get someone to try it. I dare ya.