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Neurology (Expert Forum)
Zanaflex in Migraine Prevention
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Zanaflex in Migraine Prevention
by Lauren_RN, Jul 17, 2009 08:22AM
I have been dealing with chronic migraines for 12 years; they recently became unmanageable after my 3rd seizure last year (dx with partial complex seizures & epilepsy in 2005). After trying multiple preventative and abortive treatments without much luck, my neurologist has prescribed Zanaflex each evening (starting at low dose) for prevention.
What can you tell me about the effectiveness of this medication in migraines? As it is a short-acting muscle-relaxant, I realize I will eventually have to increase my dose for efficacy, however, I am curious as to how well it works for migraines, as I am praying that this could be my solution.
Thank you for your help.
Lauren
What can you tell me about the effectiveness of this medication in migraines? As it is a short-acting muscle-relaxant, I realize I will eventually have to increase my dose for efficacy, however, I am curious as to how well it works for migraines, as I am praying that this could be my solution.
Thank you for your help.
Lauren
Doctor's Answer
by Lama Chahine, MD, Jul 22, 2009 04:55PM
, Jul 22, 2009 04:55PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
The medication classes that have been used with success include beta blockers (such as propranolol), anti-epileptics (topamax, neurontin, valproic acid), anti-depressants (tricyclic antidepressants, SSRIs, cymbalta, effexor), calcium channel blockers (such as verapamil) and a few others.
Zanaflex is not one of the more commonly used medications for migraine, but it has been studied in some clinical trials and has shown benefit. If there is a cervicogenic component to the headaches, it can be helpful for that as well. Cervicogenic headaches are headaches that result from neck problems, whether they be muscular or from the bones (arthritic, disc disease) etc. A trial of zanaflex would not be unreasonable in the right setting; while tolerance does develop to the sedative effects of it, tolerance to its muscle relaxant effects may not necessarily occur. Combination of zanaflex with other migraine prophylaxis medications can be helpful as well (i.e. it can be used as an adjuvant, meaning in combination with other medications).
Evaluation by a headache specialist, a neurologist with specialization in headache medicine, may be helpful to you if you have not had success with various headache medications to date.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
The medication classes that have been used with success include beta blockers (such as propranolol), anti-epileptics (topamax, neurontin, valproic acid), anti-depressants (tricyclic antidepressants, SSRIs, cymbalta, effexor), calcium channel blockers (such as verapamil) and a few others.
Zanaflex is not one of the more commonly used medications for migraine, but it has been studied in some clinical trials and has shown benefit. If there is a cervicogenic component to the headaches, it can be helpful for that as well. Cervicogenic headaches are headaches that result from neck problems, whether they be muscular or from the bones (arthritic, disc disease) etc. A trial of zanaflex would not be unreasonable in the right setting; while tolerance does develop to the sedative effects of it, tolerance to its muscle relaxant effects may not necessarily occur. Combination of zanaflex with other migraine prophylaxis medications can be helpful as well (i.e. it can be used as an adjuvant, meaning in combination with other medications).
Evaluation by a headache specialist, a neurologist with specialization in headache medicine, may be helpful to you if you have not had success with various headache medications to date.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
