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gobby
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Rebound question
« on: Dec 16th, 2005, 12:33am »
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What do rebound headaches feel like?  Are there different kinds?  Do they feel like CH's or are they the ones that grab you on the top of your head, like regular headachs?  Huh
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Re: Rebound question
« Reply #1 on: Dec 16th, 2005, 12:47am »
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Could come in any form. With general headaches or clusters. If its a differing type of HA than the one you are trying to stop its a byproduct or side effect
 
with CH its  just that a rebound when trying to stop a ch one way it may stop but it rebounds as soon as the deterrent wears off. often times again and again.
 
Thats the way I understand it and have experienced it.
others may have a differing perspective.
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Re: Rebound question
« Reply #2 on: Dec 16th, 2005, 1:12am »
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From speaking with my doctors, rebounds don't occur with CH.  What happens is that you get rid of one headache and then another one comes along.  Classic rebounds occur with regular headaches when the medication that you take prevents the HA from playing itself out; when the meds wear off, the old HA returns, does it's thing and then disappears.  I've been unable to find any research that supports the concept of "rebound" cluster headaches and I've asked on this site if anyone could direct me to a site that confirms the rebound theory of cluster headaches and the closest that I got was some articles on rebound migrains.  I'm chronic, so maybe the situation is different with episodics, but I've yet to find any scientific research that confirms the existence of rebound cluster headaches.
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Re: Rebound question
« Reply #3 on: Dec 16th, 2005, 1:24am »
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Tom
 
Perhaps the research just hasnt been done yet. Doesnt necessarily mean it doesnt happen with CH.
I'm sure a few will say by experience that it does happen with CH.
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Re: Rebound question
« Reply #4 on: Dec 16th, 2005, 1:26am »
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Then again it would be awfull hard to prove a CH rebound is that, as it is "cluster" HA
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Re: Rebound question
« Reply #5 on: Dec 16th, 2005, 1:29am »
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on Dec 16th, 2005, 1:12am, CHTom wrote:
I've been unable to find any research that supports the concept of "rebound" cluster headaches and I've asked on this site if anyone could direct me to a site that confirms the rebound theory of cluster headaches and the closest that I got was some articles on rebound migrains.

 
Um, Bro, did anybody from this site direct you to clusterheadaches.com.
Im sure you will find confirmation of rebound cluster headaches there. As a matter of fact, MJ just confirmed that he has had rebound clusterheadaches.
I can confirm it too.
BMonee
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Re: Rebound question
« Reply #6 on: Dec 16th, 2005, 5:14am »
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Rebound headache refers to analgesic rebounf HA.
 
When NSAID's are over used you will feel a nightmarish pain when trying to come off.
 
IT sucks.
 
You will feel a skull crushng incapacitating feeling and won't be able to move.
 
It is a different kinda of pain from CH but horrible in its own right.
 
I spent over a yr on indomethacin (for icepik HA ) and had to come off of it to try lithium for CH (Ihave mult. HA types) it was damn brutal.
 
People around here use the term rebound differently refering to something other than what Analgesic Rebound is.
 
Tom is correct from what I have read.
 
Some may find an increase in attacks "due" to what they think is a certain medication. Are those rebounds?
I don't agree but I don't write the definitions.
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Re: Rebound question
« Reply #7 on: Dec 16th, 2005, 6:45am »
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Concur with what Tom and Double said.
 
Now, some medications increase the frequency of cluster attacks for some people but these are not rebound headaches, they are an increase in cluster attacks.
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Re: Rebound question
« Reply #8 on: Dec 16th, 2005, 8:21am »
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My experience with Imitrex is that if I take it to abort, it has aborted some of the time.  But ALWAYS I get a rebound or significant cluster or whatever you want to call it on the opposite side within 1 to 6 hours.  If I tough it out which is what I have to do now, I don't get a rebound or opposite side hit.
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Re: Rebound question
« Reply #9 on: Dec 16th, 2005, 9:07am »
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Many people have many definitions for rebound.
When you're having a headache, the blood vessels in your brain are opened up.
Most medicines are designed to close up these blood vessels.
As these medicines wear off, the blood vessels return to their normal state, but in some people this state lasts a very short period, as, irritated by the drug, the blood vessels rebound - they dilate again.
This secondary dilation is the rebound phenomenon.
If the pattern of dilatation is the same, which it usually is, your original headache will return,but probably more severe. If different, you might experience a different headache.
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Re: Rebound question
« Reply #10 on: Dec 16th, 2005, 10:05am »
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Excellent review article:Rebound headaches. "Rebound Headaches--A Review", Au. John S. Warner, M.D., in HEADACHE QUARTERLY, 10:3(1999). (There is some confusion on the board about the meaning of "rebound". There appears to be an emerging consensus in the medical literature to define "rebound" as a headache which is caused by the overuse of any medication used to abort a headache or relieve pain. "Recurrence" [of a headache] is being used to refer to the redevelopment of an attack when its "normal" duration is longer than the useful life of the medication which has been taken. That is, the medication effectiveness is reducing before the headache has come to an end; the pain redevelops.)
 
"Rebound" has been renamed, in some sources, to "medication overuse headache" or "analgesic headache." But, by definition, it's a headche caused by excessive use of (abortive/pain) medications. That it is more common in migraine reflects that much more pain med is used compared to cluster (where the general theme here is that they are not drugs of choice, i.e., ineffective.) The rebound headache is experienced as the same as a "real" headache--and this is why they are hard to diagnose. The test being: Absolute stop using the suspect meds and see if the frequency of headache is reduced.
 
Rebound is found in all types of headaches because it's caused by meds use. If it's not common to cluster this is because of our not using pain meds much.  
 
(I can send longer items which won't fit onto this message board if you will send me your e-mail address.)
« Last Edit: Dec 16th, 2005, 10:10am by Bob_Johnson » IP Logged

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Re: Rebound question
« Reply #11 on: Dec 16th, 2005, 10:36am »
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on Dec 16th, 2005, 10:05am, Bob_Johnson wrote:
"Rebound" has been renamed, in some sources, to "medication overuse headache" or "analgesic headache." But, by definition, it's a headche caused by excessive use of (abortive/pain) medications.

 
That does it fine for me Bob, thanks.
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Re: Rebound question
« Reply #12 on: Dec 16th, 2005, 12:16pm »
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well I have been getting hit with major kip 9s every 2-4 hrs for about 4 days now.  I am totally stopping the imitrex (which makes me very nervous because it is the only thing that stops the beast) and am now just working on pain management.  oh I hope these are really rebounds.  One question I have....how long do I have to wait until I know if these are rebounds?
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Re: Rebound question
« Reply #13 on: Dec 16th, 2005, 12:31pm »
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I think that Rebound is so common because it flies in the face of human nature not to reach for something you know will help when you're in pain.
But if you are dealing with rebound thats just what you have to do - nothing.
I believe you should know after 1 completely untreated headache goes away by itself.
If the cycle changes, you were having rebounds. If it doesn't, most likely you weren't.
Good luck!
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Re: Rebound question
« Reply #14 on: Dec 16th, 2005, 1:31pm »
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Unfortunately, if you have true rebound attacks, you may have to be off your meds for several weeks before you see a change in your attack pattern--at least this is so when the issue is pain meds. If the change in headache is due to Imitrex, the change may be apparent sooner but I've not seen any time estimates.
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Re: Rebound question
« Reply #15 on: Dec 16th, 2005, 4:37pm »
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on Dec 16th, 2005, 12:16pm, r_headache wrote:
well I have been getting hit with major kip 9s every 2-4 hrs for about 4 days now. I am totally stopping the imitrex (which makes me very nervous because it is the only thing that stops the beast) and am now just working on pain management. oh I hope these are really rebounds. One question I have....how long do I have to wait until I know if these are rebounds?

 
Careful with this.  From personal experience and also from people here, I dont think you will get any releif from pain meds.  If you are gonna stop the trex and take vicodin or something, be careful.  Vicodin never helped me, and it actually caused rebound H/As medication overuse H/A......which for me has been the same thing as a cluster.
Have you tried taking smaller doses of Trex to see if you still get hit as badly?
Have you tried using Oxygen?
PF wishes
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Re: Rebound question
« Reply #16 on: Dec 16th, 2005, 6:37pm »
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I know my perspective on this is unpopular, since what I feel were rebound (or increase in attacks and severity) were due to both Imitrex and Oxygen in different cycles. I am quite happy many find great relief with these, but last cycle I didn't even try them. Oxygen, like Imitrex, caused me to get a recurring high KIP level attack as soon as it "wore off". I sat for half a day breathing oxygen to try to avoid getting hit again. It did abort fairly soon, but within 30 minutes of taking off the mask, I'd get hit again. What a nightmare! Almost as bad as when an attack never seems to stop toward the end of a cycle. I've read that the new mask from the UK works much better, and may not have the "rebound" effect that I experienced before. I'll try it next round! Best of luck - Rich     P.S. Maxalt didn't do this to me during recent cycle. Very odd since it's much like Trex?
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Re: Rebound question
« Reply #17 on: Dec 16th, 2005, 7:12pm »
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on Dec 16th, 2005, 10:05am, Bob_Johnson wrote:
The test being: Absolute stop using the suspect meds and see if the frequency of headache is reduced.
 
Rebound is found in all types of headaches because it's caused by meds use.

 
This is why I love this guy....always comes to the table with facts.
 
First time I took Trex was at the Atlanta convention, it was a beast killer for me. But, the more I took the more HA's I got.......Simple, stop taking it and see what happens...Duh!
 
My HA's were cut by more  than half after that.
 
Bob J, your one hell of a researcher my friend...headbanger
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Re: Rebound question
« Reply #18 on: Dec 16th, 2005, 8:16pm »
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You may think I'm crazy, but I don't believe a returning Cluster Headache is a rebound if it was originally aborted through Trex or O2. It was just finishing what it needed to do to complete the CH cycle.  
 
Lets' say a normal CH lasts 90 minutes and you stop it short of completeing the full 90 minute cycle in say 15 minutes with O2 or Trex. There are 75 minutes remaining on that Cluster for it to end. Therefore the CH will return sooner to complete its' mission. If you continue to abort, the CH will keep returning until it's finally finshed its' cycle.
 
You're damned if you do and you're damned if you don't. Either no meds and suffer a 90 minute full blown Cluster, or keep aborting 5 times or so until the CH has finished its' job.
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Re: Rebound question
« Reply #19 on: Dec 17th, 2005, 12:15am »
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Damn, Meanie, now that is a scary thought...but something to think about.  smiles,nancyc
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Re: Rebound question
« Reply #20 on: Dec 17th, 2005, 1:49am »
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Wow! I sure learned a ton about "rebound" headaches, including the fact that I had entirely no clue what I was asking. LOL  I guess I wanted to know about "withdrawl" headaches.  Since I have been drinking a lot of caffine lately and am gonna' try and lower that soon.  Sorry for the mix-up, but it just gos to show how someone can use the wrong term for something and not even know it.  I know better now. Tongue
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Re: Rebound question
« Reply #21 on: Dec 17th, 2005, 2:04am »
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Oh!
 
Cant help you then. Besides its too late this subject is better, and we are sticking to it.
 
Have another weaker cup on me. That will help the withdrawal headaches.
 
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Re: Rebound question
« Reply #22 on: Dec 17th, 2005, 7:18am »
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ok...well I have not taken any imitrex for 36 hrs now...I have been on the Kudzu 900mg in the morning and 900mg in the evening.  also on 240mg of verap. once per day.  to keep the beast away I have been taking 800mg of motrin three times a day and 2 percocets every 4-6 hours.
 
I started this mixture 36 hours ago....and the result....not even one attack.....a few shadows but that is all.  I slept almost 14 hours without waking up and I feel great today.
 
I only hope the frequent hits were a result of the excessive use of imitrex!  thanks for all of the info! Cheesy
 
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Re: Rebound question
« Reply #23 on: Dec 17th, 2005, 7:34am »
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on Dec 16th, 2005, 8:16pm, BlueMeanie wrote:
You may think I'm crazy, but I don't believe a returning Cluster Headache is a rebound if it was originally aborted through Trex or O2. It was just finishing what it needed to do to complete the CH cycle.  
 
Lets' say a normal CH lasts 90 minutes and you stop it short of completeing the full 90 minute cycle in say 15 minutes with O2 or Trex. There are 75 minutes remaining on that Cluster for it to end. Therefore the CH will return sooner to complete its' mission. If you continue to abort, the CH will keep returning until it's finally finshed its' cycle.
 
You're damned if you do and you're damned if you don't. Either no meds and suffer a 90 minute full blown Cluster, or keep aborting 5 times or so until the CH has finished its' job.

This is what happens with mine!!!!  OMG Blue, you hit it right on the nose for me!  That is one reason why O2 and me don't mix well (I'd have to huff for a long time to keep that particular attack from returning), but trex does, due to my attacks only last for 50min. (I believe it's due to the 1/2 life of the trex??).
 
It is like the attack has to run it's course, or you end up fighting more and more and feeling worse and worse.  It's an interesting phenomena(sp) that should be looked at more.
 
mel
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Re: Rebound question
« Reply #24 on: Dec 17th, 2005, 8:48am »
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A message here notes a "rebound" effect with O2. In the enthusiasm for O2 this potential has been lost from sight although it was noted in the literature several years ago. Not true rebound, I think, but--my guess--because it works so rapidly and clears the body quickly, oxygen can abort an attack and then it redevelops before the body has made a full recovery from the headache processes involved.
--
 Neurol Sci. 2004 Oct;25 Suppl 3:S119-22. Related Articles, Links  
 
 
Cluster headache: symptomatic treatment.
 
Torelli P, Manzoni GC.
 
Headache Centre, Section of Neurology, Department of Neuroscience, University of Parma, Via Gramsci 14, I-43100 Parma, Italy. paolatorelli@libero.it
 
The clinical management of cluster headache (CH) attacks requires a symptomatic treatment that is rapidly effective in resolving or significantly reducing symptoms. First-choice drugs for the symptomatic treatment of CH are subcutaneous sumatriptan at a dose of 6 mg and 100% oxygen inhalation at a rate of 7 l/min for no more than 15 min. Sumatriptan acts by suppressing pain and the accompanying autonomic phenomena, with no substantial differences in its mechanism of action between episodic and chronic CH. The drug can be used for prolonged periods without loss of efficacy or safety and its side-effects are generally mild or moderate. Oxygen inhalation has a number of advantages over drug therapy: it is free from side-effects, has no contraindications--unlike sumatriptan, it can be used in patients with cardiac, cerebral or peripheral vascular disease and with kidney, liver or lung disease--acts rapidly and can be administered several times a day. Its disadvantages are that it is scarcely practical and may induce a "rebound effect". Sumatriptan nasal spray, zolmitriptan and dihydroergotamine nasal spray are scarcely effective. After the introduction of sumatriptan, ergotamine tartrate has been relegated to a secondary role in the symptomatic treatment of CH. Among other non-drug and topical drug treatment options, hyperbaric oxygen therapy and the intranasal application of 10% cocaine hydrochloride and 10% lidocaine in the sphenopalatine fossa have also proved effective.
 
PMID: 15549518 [PubMed - indexed for MEDLINE]  
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