Effect of Amitriptyline and Propranolol Prophylaxis on Heart Rate Variability and Lipid Profile in Persons with Migraine: A Prospective Cohort Study

Migraine is a prevalent primary headache disorder marked by intense headaches and heightened sensitivity to sensory stimuli. Propranolol and amitriptyline are commonly prescribed for migraine prevention, but both medications can influence heart rate variability (HRV), impacting treatment outcomes. Research indicates that amitriptyline may reduce HRV, particularly in depressed patients, although it might enhance HRV in those experiencing neuropathic pain. In contrast, propranolol generally increases HRV, although its effects can vary among populations, such as those with hyperthyroidism. Additionally, amitriptyline is associated with unfavourable lipid profile changes, including elevated cholesterol and triglycerides. Given the established link between HRV and cardiovascular health, monitoring lipid profiles in patients treated with Propranolol and Amitriptyline is crucial to mitigate cardiovascular risks. This study aims to investigate the differential impacts of propranolol and amitriptyline on HRV and lipid profiles in migraine patients, ultimately enhancing migraine management strategies while addressing associated cardiovascular concerns.