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Ivor
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Imitrex - Imigran
« on: Jul 2nd, 2005, 7:11am »
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Hello everyone. I am just coming through the worst bout of attacks I have had in 7 years.  
I use Imigran - Sumatriptan injections. I have tried numerous other forms of medication, most of which are mentioned elsewhere on this site, but this is the only effective way I have of stopping the pain. The problem is I am only allowed 2 injections within a 24 hour period. Take one at say 0200 in the morning and then another at midday - what do you do for the remaining hours - suffer basically. I spoke with my Doctor and told her that I wanted to take more than 2 in 24 hours and I was willing to take any risks involved. She got in touch with Glaxosmithkline, who produce this drug. They faxed through some information regarding the use of more than the clinical recommended dose of 2 injections in 24 hours. These showed that none of the patients who had injected more than 2 times in 24 hours suffered any side effects other than those normally associated with the use of this drug, although this information dated back to 1996.
I have taken over 90 injections since the 2nd of June and I can say that as yet I have appear to have no adverse conditions. My blood pressure is ok etc.  
I have a record of all of the attacks I have had over the past month - including the one a few hours ago, listing how I dealt with it - oxygen, injection or rocking/pacing, including length of time and pain rating. Sorry it's a long message.  
Ps. I have a very understanding Doctor...these cost £22.00 per injection!  
Kindest regards to everyone...  
Ivor  
PPs I am new to this message board thingy and I had already posted this in the wrong place. I have been advised to post it here instead Shocked)
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Bob_Johnson
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Re: Imitrex - Imigran
« Reply #1 on: Jul 2nd, 2005, 7:25am »
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While the medical literature suggests that there are few concerns about the amount of Imitrex you are using, several folks here agree with the potential problem noted in this article.
 
: Headache. 2004 Jul;44(7):713-8.  Related Articles, Links  
 
   
Subcutaneous sumatriptan induces changes in frequency pattern in cluster headache patients.
 
Rossi P, Lorenzo GD, Formisano R, Buzzi MG.
 
Objectives.-To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature. Background.-Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial. Methods.-Six CH sum-naive patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described. Results.-All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. In all patients, the CH returned to its usual frequency within a few days after SQ sum was withdrawn or replaced with other drugs. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache. Conclusions.-Physicians should recognize the possibility that treatment of CH with SQ sum may be associated with an increased frequency of headache attacks.
 
PMID: 15209695 [PubMed - in process]  
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Since there is no way to sort out "normal" clusters from those induced by the Imitrex it might be worth considering intermixing other abortives with the Imitrex.
 
Many folks here love oxygen; you should examine the OUCH site in England for ideas. Personally, I've had good results using this med:
1: Headache 2001 Sep;41(Cool:813-6  
 
 
Olanzapine as an Abortive Agent for Cluster Headache.
 
Rozen TD.
 
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.
 
OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. The initial olanzapine dose was 5 mg, and the dose was increased to 10 mg if there was no pain relief. The dosage was decreased to 2.5 mg if the 5-mg dose was effective but caused adverse effects. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and two patients became headache-free after taking the drug. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. It alleviates pain quickly and has a consistent response across multiple treated attacks. It appears to work in both episodic and chronic cluster headache.
 
 
 
------------------------------------------------------------------------ --------
 
Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Ivor
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Re: Imitrex - Imigran
« Reply #2 on: Jul 2nd, 2005, 7:50am »
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Hi Bob,
Many thanks for the information you have given me. I am taking Deseril - Methysergide in conjuction with the Injections. The dose is 2mg 3x a day. Upon taking this drug, the headaches disappeared for 2 days and then returned. Since taking the drug the frequency of the attacks has reduced, although I had already felt that the 'worst' had already taken place the previous week. I am still taking 2/3 injections a day. I have no problem in coming of the injections and taking whatever the beast throws at me, if I need to find out if the injections are in fact making things worse. I have noticed that if I take an injection when the pain is at say a level 6, it will move up the scale almost immediately the injection has entered my body. I have tried oxygen at the prescribed dosage - last time I used a whole bottle and resorted to an injection, so I have very little faith in that method, although I have been informed that I could use a different mask, so I will look into that asap.
Kindest regards
Ivor
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SusieWong
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Re: Imitrex - Imigran
« Reply #3 on: Jul 2nd, 2005, 10:23am »
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Hi Ivor,
 
Sorry to hear that you have had such a bad time through this bout.
I do hope that you have found the UK support group - OUCH UK:
  www.clusterheadaches.org.uk
 
Do take a look at the site, there is a help board and lots of useful information about the UK meds which a do vary and also have different names.
 
A lot of members have had good success recently with a relatively new triptan - Frovatriptan. It has a half life of 26 hours compared with Imigran which has a half life of just 4 hours.  You do not need to be a member to post and ask for advice.
 
Hope that you are soon pain free.
 
Susie
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Re: Imitrex - Imigran
« Reply #4 on: Jul 5th, 2005, 8:36am »
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In regard to Zyprexa: I took this medication in 2001/2002 for a coupple of months, and the summer of 2002 was painfree except for one hit. they are clearly on to something, the only side-effect I experienced was in fact drowsyness, which isn't a problem as long as you take it at night before going to sleepSmiley
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