Yes, it is possible for a migraine to last 21 days; this is a continuous state that requires medical attention. It is also very common for symptoms to return quickly if you miss a dose of a daily preventive like Inderal (propranolol), as consistent daily levels are key to keeping migraines at bay. To help manage this chronic cycle, I highly recommend consulting a neurologist, ideally a headache specialist. They can tailor a plan to break this cycle and help you find long-term relief safely.

Both Inderal and propranolol are the same medication, so your doctor is adjusting your dose to find the right balance for you. As you transition to the 80 mg dose, it can help to limit caffeine, stay well-hydrated, and get plenty of rest, as fatigue can worsen shaking. I recommend keeping a daily log of when your tremors are most noticeable. Since some of your other medications, like Dicorate ER, can also cause tremors, sharing this log with your doctor will help them safely adjust your care.

It is very common to feel tired when starting Inderal (propranolol) and Topirol (topiramate), as both medications can cause fatigue as your body adjusts. Regarding your lab results, an ESR of 50 suggests mild inflammation, which can sometimes be linked to chronic headache conditions. A zero monocyte count is unusual and often represents a minor lab variation, so it is best to have this rechecked. Please try not to worry, but do share these results and your fatigue with your prescribing doctor so they can evaluate your progress and ensure you feel comfortable.

Taking Inderal (propranolol) and Prothiden (dosulepin) together requires caution, as they can interact. Prothiden can sometimes affect your heart rhythm or reduce the heart-lowering effect of Inderal. It is best to have your doctor review this combination to ensure it is safe for you. Regarding your heart rate of 93 beats per minute, this is within the normal resting range of 60 to 100 beats per minute. However, since you are taking Inderal, please share this reading with your doctor to ensure it is expected for your specific treatment.

Based on your symptoms of hand shaking that worsens with stress and activity, you may have a common condition called Essential Tremor. While I cannot prescribe medication online, the most frequently prescribed first-line treatments are beta-blockers (like Propranolol) or anti-seizure medications (like Primidone). These help reduce the shaking during tasks. Because these drugs affect heart rate and blood pressure, you must consult a doctor or neurologist for a proper diagnosis. They will evaluate your health and safely prescribe the right medication and dosage for you.

Adding Anafranil (clomipramine) can help treat premature ejaculation, but it can interact with your daily bupropion and mirtazapine, so close medical supervision is essential. Rivotril (clonazepam) is not a standard treatment for this. At age 25, male hormones will not increase penis size, and taking them can cause harmful side effects. Crucially, please never inject HCG or HMG into your veins, as intravenous hormone injections are extremely dangerous. I strongly encourage you to discuss safe, effective treatment options with your doctor or a urologist.