From the Research
The recommended dose of verapamil for reversible cerebral vasoconstriction syndrome (RCVS) is 120 mg once daily, using a controlled release formulation, as supported by the most recent and highest quality study 1. This dosing regimen is based on a systematic review of 58 articles, including 56 patients with RCVS treated with oral verapamil, which showed improvement in headache in 54 out of 56 patients, with minimal adverse effects. Key points to consider when using verapamil for RCVS include:
- Starting with a controlled release formulation of 120 mg once daily
- Monitoring blood pressure regularly due to the potential risk of hypotension
- Being aware of common side effects such as constipation, dizziness, and headache
- Using verapamil cautiously in patients with heart conditions, particularly those with heart failure or conduction disorders
- Regular follow-up with a neurologist to assess treatment response and adjust dosing as needed, as reported in the study 1. It is essential to note that while verapamil appears to be well-tolerated and effective in improving symptoms, there is still a need for randomized controlled trials to confirm its efficacy and optimal dosing regimen, as highlighted in the study 1.