New here, and I have a questions about Blood Pressure and Nicotine/Alcohol

New here, let me introduce myself 🤝
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Hi, I’m Joey, I’m 24 and have been dealing with what I think is MAV since 5/19/2018.

I was driving 3 hours to pick up my fiance from an airport during a very high stress period, and I had a sudden feeling of extreme exhaustion and imbalance. I thought I was just tired, so I got an energy drink, and the exhaustion slowly went away but the balance issue got much, much worse. I used to drink 3-4 cups of coffee a day, so I’m normally extremely tolerant to caffeine, but I couldn’t stay between the lines on the highway and had to pull over. The feeling did not go away for months. Looking at these forums over the past day, I am relating to most of what I see as the symptoms. I feel a general dizziness, with some eye focusing issues and brain fog 24/7, and I get the sensation of “Spongewalking” when I walk. I also get extreme exhaustion when my dizziness symptoms increase, almost to the point of falling asleep on the spot. I already had anxiety, and now its through the roof.

I live in a tiny town in the middle of nowhere in Texas with only one ENT close by. It takes me over a month to get an appointment. I went to her 2 times before she said it could be MAV and proscribed Verapamil (160mg a day). I felt slowly better over the next month, and at the end of the month I felt nearly 100%. I went back and she said that she thought I was better, and I should stop taking the Verapamil because it lowered my blood pressure to 80/55. I did, and within a week the symptoms came back. I cant get another appointment for another month, and my MAV symptoms have been so bad since I got off the meds that I can barely work, let alone do the traveling I need to do for work (I have a ton of upcoming flights). I started taking the Verapamil again on my own, since I am feeling absolutely awful right now.

Does anyone else have low blood pressure issues when taking Verapamil? I get whoozy when I stand up too fast on it, and need to take shorter showers to avoid feeling like I am going to pass out. If so, what do you do to remedy it?

When I was diagnosed with MAV, I was told to quit smoking and drinking. I used to smoke cigs and E-cigs heavily, and drank at least a bottle of whiskey a week. Smoking has always been a way for me to release stress, and I can’t take all this stress while not using Nicotine. Does Nicotine make your symptoms worse? What about alcohol? I love red wine but it has always been a trigger for massive migraines throughout my life, so I’m expecting it to be a trigger for MAV too. Can anyone here drink liquor or beer without making MAV symptoms worse?

I’m really happy that I found this forum, the stories I have seen have given me hope at a time when I am really depressed.

Thanks

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Hi, and welcome. Sorry to hear your predicament. I cannot help you with regard alcohol or smoking as I use neither. As a long time sufferer of MAV I would advise you to continue yr searching on this site. There’s alot of information here to help you understand MAV which can be a chronic and debilitating condition for many that takes a good while to resolve. The resolution generally lies with preventative meds, following a strict migraine diet (which excludes alcohol) and modifying lifestyle or making changes to it two prominent of which are usually reducing stress and slowing up a bit in various ways.

Verepamil is a calcium channel blocker designed to lower blood pressure,. It is regularly and successfully used as a migraine preventative but there are other drugs of different classes that do the job as well so I would imagine a phone call to yr specialistmsy set you on the path with an alternative. Good luck.

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Thank you. I have been prescribed to antidepressants in the past for non-migraine related issues, and I had some fairly serious issues with them. Does anyone know if beta channel blockers have less on an affect on blood pressure than calcium channel blockers do?

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I had low blood pressure symptoms while getting on Verapamil. Feeling like passing out when getting up and stuff like that. But my numbers were never that low. I started on a very small 20mg dose and worked my way up over 3 months to 360mg. In my case, my body adjusted over time to keep my blood pressure. There was no way I would have handled 160mg for the first month. For my first month I was between 20-80mg.

I wonder if you just take a lower dose of Verapamil for a while and see if your blood pressure will correct itself over time. If so, then up the dose, wait for it to settle, then up the dose, etc… Worked for me anyways. My blood pressure got down to 105/65 or something like that and I could definitely feel it. Now its about 120/80, even with a 360mg dose! And I exercise a lot too.

Yes, you want to try to quit smoking and drinking over time, not good for MAV. I quit tobacco about 9 months ago which was hard but I was not much of a drinker. Caffeine is also bad for me, even in small quantities like some green tea. It’s hard to quit addictive substances when you are so stressed, I know. I would take these things one step at a time though. I personally felt that tobacco/caffeine was worse than alcohol, probably because of the vasoconstricting effects. I think it would be helpful to get some counseling support too, as anxiety is one of the most prominent issues with MAV.

Let me know if you have any more questions, as I have definitely had significant improvements on Verapamil, its a good drug overall I think. But, everyone is different, maybe its not your thing.

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I also read that alcohol + verapamil can lower your blood pressure much more than verapamil alone. So, I would look into that.

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And, of course, many many drugs have written instructions saying that alcohol shouldn’t be taken whilst on them.

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No idea, but betablockers aren’t used as commonly to reduce blood pressure as they might have been previously, calcium channel blockers are much more commonly used to lower blood pressure specifically. I take betablockers for MAV and they were offered to me first because my blood pressure is on the high side aiming to control the two conditions with one drug. However in my case they haven’t reduced my blood pressure at all. It’s still high side of normal. Much depends on individual’s sensitivities I suppose. Of course usually the dose levels for MAV are lower than the doses for control of blood pressure. Antidepressants are similar, MAV dosing is usually, not always, only less than one quarter depression dose. You say you’ve had adverse reaction to antidepressants before. Recently? They do tend to react differently in the Under 25’s!! I’m not a doctor so no idea why but might be worth bearing it in mind. Another drug class also used for MAV is technically anticonvulsant, Topiramate Being a first choice for many specialists so don’t worry, you haven’t yet run out of options. MAV treatment is very much trial and error for everybody, many trial several drugs initially unsuccessfully. That’s how it goes.

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Thanks for the replies. I will continue to avoid Nicotine and Alcohol. It is good to know that the doses for migraines are lower than the doses are for high blood pressure or depression for their respective drugs. I had issues with depression as a teen (what teen doesn’t) and SSRIs made my depression much more serious. I will definitely do more research into these along with Topiramate, and ask for a lower dose of the Verapamil.

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One other thing is don’t assume that antidepressants won’t help you because of your experience as a teen. Things can change as you age. Many people on here have had great results on various antidepressants. I’ve had completely different results with the same antidepressant 20 years later in life. If you do try one, just start on a really low dose and go really slow. Like 1/10 dose that a psychiatrist would prescribe.

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I think you can discount yr teen experience with antidepressants. You’re adult now. It does affect Under 25’s significantly differently. You can read that lots of places on the net.

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I will definitely talk to my doctor about it, thanks!

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I used to love a nice bottle of red wine. I switched to white, unthinkable a year ago. Seems less problematic. Vodka is said to be the least problematic of all.

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Any luck with whiskey?

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Ha ha…funny…how about Gin?:smile:
Jo x