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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Nortriptyline-so far so good?
        
(Message started by: spanky on Oct 9^th, 2003, 3:15pm)

Title: Nortriptyline-so far so good?
Post by spanky on Oct 9^th, 2003, 3:15pm

Ok here goes...
I just joined the club after a few months of quiet, painful observtion. Thought I'd relate my experiences to y'all for what they are worth.
I started suffering from recurring headaches 4 years ago and lived in periodic agony of the known (the intense pain) and the unknown (tumor? thrombosis? aneurysm coming my way?). Finally, about 2 years ago I did homework surfing the net and diagnosed myself as a cluster headache sufferer. What a relief it was to finally know why I was subjected to such excruciating pain, though I was still far away from any tangible, reliable relief.
Though it has only been 4 years since the CH's began, it seems like I've had them forever. They may have been episodic at first but they soon progressed to chronic and would generally occur at least 3-4 times a week and sometimes up to 3-4 times a day. I have never experienced any substantial "off cycle" or remission during the last 2 years. 2 or 3 days is the most I have gone without dancing with the devil. During the last 3 years the norm has been 2-3 headaches per day every day.
My symptoms are relatively classic: pain always concentrated in the right temple/eye area and seeming to originate from the base of the skull around and over the right ear. Right nostril/sinus cavity congested as attack progresses. Extreme sensitivity to light and noise and don't even think about expecting me to converse or "sleep it off". Headaches typically lasting about 2 hours. Pain intense as only a clusterhead can imagine. Morning, afternoon, middle of night all fair game for attacks. I began treatment by trial and error and soon found that hot or cold towel/shower and intense massage(God bless my wife) seemed to help to eventually alleviate the pain. Never has worked completely as an abortive but would help to gradually ease the monster back into it's foul resting place.
Up until June 2003 I was living 3rd world abroad and had no reliable medical resources. Soon after I returned stateside to Texas I saw a neurologist who confirmed my diagnosis and prescribed Imitrex injections for abortive and Nortriptyline (50mg) for maintenance. Just prior to this I had tried Imitrex pills a number of times as abortive; in each case it had taken at least 30 minutes for any relief and even then I wasn't sure if the headache hadn't simply run its course on its own. At this same time I also had access to an oxygen bottle and this seemed to provide abortive relief after about 30 minutes. For me, Imititrex injections work fantastically in 5-10 minutes; they're just so damn expensive! Cheap bastard that I am, I suffer through most and only inject if I'm at the crying helplessly looking for the shotgun phase.
Anyways, after taking a week's startup of 25mg Nortriptyline I increased to 50mg for the next month. I still had daily headaches but they seemed to be somewhat reduced in frequency and severity. The doctor increased my dosage to 75mg at bedtime which I have been taking now for the past 6 weeks. I had not one single headache for almost a month straight. I have had a few shadows in this time but they have faded away after hanging threateningly for a half hour or so. Twice in this last week I have been woken at night by a headache that has been moderate in intensity but which lasted only about 30 or 45 minutes.
I don't know if these recent headaches are an indication of my building a tolerance or if it means that the Nortrip is only a "one-hit wonder". But I do know one thing. These last few weeks pain-free has been sweeeeet! Everyone out there suffering from this monster, I empathize and sympathize with you. I may be chronic again someday but I will never let it defeat me. For now I think the Nortrip is a salvation and I'm so happy to be momentarily rid of the monster.
Any comments or advice to me regarding the use of Nortriptyline or other medications will be appreciated.

I thank you all for providing your insights and experiences to this forum. I am glad to finally find people that understand fully what I understand only too well.
Spanky

Title: Re: Nortriptyline-so far so good?
Post by Bob P on Oct 9^th, 2003, 5:31pm

A little something on trycyclics:
http://www.clusterheadaches.org/library/medications/tricyclic_antidepressants.htm

I'm definately going to give Elavil a try next time.

Title: Re: Nortriptyline-so far so good?
Post by spanky on Oct 10^th, 2003, 6:09am

Hey Bob,

Will the Elavil be a first-time try or have you tried tricyclics before? I haven't noticed any significant side effects from the Nortriptyline other than a slight increase in appetite (and my skinny butt can afford that).

Title: Re: Nortriptyline-so far so good?
Post by forgetfulnot on Oct 10^th, 2003, 10:56am

Hey Spanky, how much Nortriptyline do you take and at what time of day?

Lee

Title: Re: Nortriptyline-so far so good?
Post by cathy on Oct 10^th, 2003, 3:58pm

Hi Spanky sorry your here but welcome aboard the board.....sorry you have to deal with the devil on a daily basis!

PF vibes to you from across the pond.

Cathy :)

Title: Re: Nortriptyline-so far so good?
Post by spanky on Oct 10^th, 2003, 4:07pm

Hey there Lee...

I'm taking 75mg every night just before beddy-bye; about 10pm. Still 95% PF...shadowed for about 30 minutes just after noon today and I smote the beast upon its wicked crown.

"I stand up next to a mountain.....and I chop it down with the edge of my hand"

Hi Cathy! Thanks for the welcome and what side of which pond might you be greeting from. Ohh that pond. Never mind, if I wasn't wandering aimlessly I would have recognized your accent :) Speaking of that pond, I'm on the last pages of Winston Churchill's memoirs. Fascinating read.

Title: Re: Nortriptyline-so far so good?
Post by Bob P on Oct 10^th, 2003, 5:00pm

I tried the Elavil once before. Probably 7 years ago. I took 50mg the first night and was super groggy in the morning. That night I lowered the dose to 25mg at bedtime and was still groggy in the morning so I quit taking it.

Next time I plan on hanging in there through the grogginess. I'm told it gets better after a week or two. At least I plan on giving it a decent trial.

Title: Re: Nortriptyline-so far so good?
Post by Zonie on Oct 10^th, 2003, 7:29pm

Welcome Spank....sorry that you had to seek us out, but glad that you found us. I have been taking Elavil for over a year now...75 mg at bedtime. Dr. started me with 25 mg, then 50 and now it's at 75 and seems to be losing it's powers. I am a chronic who has tried almost everything and am presently using Cafergot as an abortive. It works for me as well as did the Imitrex and is not nearly as difficult to obtain. Problem being that right now I'm having to take about 2 or 3 times the amount that I should due to elevation in frequency and intensity. When I first started on the Elavil the frequency and intensity was decreased substantially. But like you said, I don't know if I have built a tolerance to it or need to up it another 25 mg, but I go to see a new neuro on the 27th.

Here's hopeing that you remain PF for many more days and enjoy every minute of it.

Zonie

Title: Re: Nortriptyline-so far so good?
Post by ncmountains on Oct 10^th, 2003, 8:00pm

Perhaps it was the change in the altitude or climate that caused this instead of what your doctor prescribed. It is a possibility. I feel like I am a human barometer with the weather...I am very sensitive to these things. My last bad bout with these darn headaches was January 2001. This lasted for 3 weeks, when I had to stand out in freezing weather, my next was May 2002, when all the pollen came in. Spring time, change of temperature, The headachew lasted for 4 weeks. I left the mountains of WNC and went to the coast (change of altitude). My headaches were gone that day. Why is this? Ideas please?