Hi, my Doctor prescribed me a few of the 6mg Sumatriptan injections to trial as a way of dealing with daytime hits when I am out and about. I tested them last night and found that they abort a hit quickly, 10 minutes, but I get a rebound within 4 hours. Is this usually the case?

Hi ...My hubby sometimes does get rebound from shots, but not very often. He usually has to use one a day though, yesterday he had to use two. If he does get a rebound, then he ends up at the ER, because that is when the shot will not help the second time around.

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.)
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Sumatriptan has a hard initial punch and relatively short effective life--a combination which works well for most Cluster attacks. However, some people, whose Clusters have a longer life, find that the med is wearing down even as the pain continues. One can understand how this sequence comes into one's thinking: Attack, Imitrex injection, pain continues, it's a rebound cluster which has developed from the Imitrex. In fact, this is a recurrence of the attack, not a rebound.

This is one of the reasons that several other triptans were developed having less initial punch but longer effective life. While aimed at the migraine crowd, at first, a number of cluster users have found this characteristic of value to them.

Bottom line: discuss the value of changing to a longer acting triptan before you make a judgment about the value of this class of meds.

Thanks for that Bob, so I guess that what I am talking about is a recurrence within a shorter time span than what I would normally expect.

My neurologist rec that I take oral imitrex if the headache comes back within 2+ hours after the injection.  (As Bob commented, Imitrex works great but is a short acting triptan). I have tried ZOmig,Relpx and Maxalt and they didn;t touch the cluster headaches. )

I agree re the Imitrex.  Great initial results, but I got in to a terrible loop about 6 years ago where I kept trying to abort rebounds, and ended up in the hospital with the worst episode of my life.
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I'm off cycle now (THANK GOD) but when I'm on, the regimen is O2, Zomig.  Imitrex is my last resort now, I feel like it causes me more hassle in the long run. 

It was the same for me. Imitrex injections worked great at first, but then it was like I was getting rebounds. If it was or not a recurrence of the same attack I don't know, but I don't seem to have this problem with Zomig nasal spray (though I try to use it as little as possible). It might be a longer shelf life triptan... In any case it works for me... for now!

Bob Johnson wrote on Feb 11^th, 2013 at 7:38pm:

In fact, this is a recurrence of the attack, not a rebound.

Recurring attacks may be a fact, but in my experience there is no doubt regarding Imitrex causing new attacks, and more frequent attacks, especially when used to stop nocturnal attacks. I've found that from time to time I have to bite my teeth together, and suffer an attack without any medication in order to get out of the loop. In fact the Imitrex-attacks have a special "sourness" to them, they are easily recognizable.

[quote author=467975687B79756F681C0 link=1360603495/7#7 date=1361896721
In fact the Imitrex-attacks have a special "sourness" to them, they are easily recognizable.
[/quote]
Thats exactly what I found. I got one hit and aborted it with the Sumatriptan, 4 hrs later came the next one, aborted again, the next day a hit arrived at 9 AM and stayed the whole day, low level certainly, but nevertheless painfull and unsettling. That happened twice and I decided that its not for me.

I also use Imitrex injections as a last resort. If I do resort to using an injection, it seems to bring on more attacks and more severe attacks. So, the more I use ... the more I HAVE TO use Imitrex :(   It's a vicious cycle of pain !

I4B