Migraine Prevention - I suffer from chronic migraines and have recently started on Verapamil 180mg?

This is not a high dose if it is an extended release tablet. Verapamil can be taken for high blood pressure as well and the that is given 240mg exteded release in the morning as a starting dose. So 180mg is NOT a high dose. Some folks take 480mg a day (240mg in the am and 240mg in the pm) for blood pressure. Beta blockers can cause fatigue especially when starting therapy. It is possible this medicine might be lowering your heart rate too much. Count your heart beats or pulse for a minute. If they are below 56 beats per minute talk to your Dr about it. Beta blockers lower the heart rate and for some, when it lowers the heart rate too much, it makes them very tired. If this is the case, and you are under 56 bpm, he may need to adjust the dose. If you are running 60bpm or above, the fatigue should get better as you are on the medicine longer. It will take awhile before you notice improvement in your headaches so be sure to give it some time, if you can stick with it.

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I take Atenolol, which is also a beta blocker, for my blood pressure and incidentally my migraines have nearly ceased. I used to get several a month, now I only get a couple a year! This medicine is one that you are not supposed to take with grapefruit juice so be sure you are not drinking grapefruit juice or eating grapefruit when you take the medicine. You also want to avoid alcohol use while on this medicine. Verapamil can inhibit alcohol elimination so the alcohol can build to dangerous levels and could poison you! Make sure you stay well hydrated and be sure to get a good fiber intake as the medicine can cause constipation and staying hydrated can also help your headaches. Be sure you dont break, chew or crush your tablet because it is time released and altering the pill can cause you to get too much medicine at once. Do you keep a headache diary at all? I found, by keeping a diary of everything I put in my body, that tomatoes and red wine are definite migraine triggers for me. Keeping a diary can help you to see patterns and might help you to eliminate some of your headache triggers.