Hi,
Been away from the forum for few years, I am in Egypt and there is no Imitrex here, is there any alternatives ?

As reference about me I still get attacks each year the only thing that work with me until now is O2 also tried D3 but did not work with me even with high dosage.

Could be known as Imigran in your part of the world.

Hoppy

Hey CCH,

Good question.  Check out the following link for an answer... 

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

If that doesn't work shoot me a PM.

Take care,

V/R, Batch

Print the PDF file, below, and use it to discuss options with your doctor.

If this is available, I'd recommend giving it a try.
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Headache 2001 Sep;41(8):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.

PMID 11576207 PubMed

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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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Hoppy wrote on Jul 25^th, 2015 at 1:38am:

Could be known as Imigran in your part of the world. Hoppy

Yes we have imigran, thanks

Thanks Batch, Bob Johnson you all are real friends in my difficult times.

I am currently taken Depakine two pills daily + one pill of cipralex, can cipralex be a good replacement for ZYPREXA ?

No; Cipralex is use to treat depression and is not the same type of drug.

Olanzapine was not intended to treat Cluster. One of the best headache doctor in the U.S. just found its benefit by accident. One of those events which you can't plan.

My personal experience with olanzapine was so good that I stoppped using any other abortive medication for my Clusters. In the U.S., it's inextensive and, being a pill, it's easy to carry with you (compared to an injection or spray).

Your drug store or doctor can tell you whether it's available.

In the U.S. it much less expensive compared to many of the other abortive meds. used for Cluster.

Thanks Bob looks like a new hope.

@Bob
How long it take until ZYPREXA take effect ? I am currently having attacks for 30 minutes so is it fast like O2 ?

Zyprexa works as a preventative like Verapamil and Lithium. It will take a week or two to kick in.

Hoppy

And for how long I should take it ? should the dosage reduced gradually ?

Olanzapine is not a preventive like Verap. although, as you will read below, in a few cases it apparently stopped Cluster completely.

Its used is as an abortive when you are having an attack. It works in about 20 minutes. As with all abortive meds, you use it when an attack is developing--and use it as the first sign of an attack.

Not used on a regular basis to prevent attacks.

Thanks Bob, should I take the 5 mg or 10 mg ?

I was on 5mg Zyprexa taken at bedtime for a number of years, and in all that time had no Spring or Autumn episodes, but because of weight gain my GP suggested I stop taking it which I did. That was a couple of months before Spring of 2012. Then come Spring as per normal the beast came a calling, back to my GP I went who then put me on Imigran  tablets, and the rests history. I'm now on the vitamin D regime and CH free.

Hoppy

Your question about dose size: follow the procedure outlined in the medical abstact above:try 5mg, moveto  10mg if 5 doesn't give good, fast relief.