Hello all,

My husband is a 10+ year sufferer.  I was there when he had his first episode and I truly thought he was going to die...what an awful feeling to be so completely helpless.

After many years of incorrect diagnoses and medications, we finally found a nuerologist who actually understood what my husband was going through and diagnosed him.

My husband has been finding quick relief with Imitrex injections for approximately 5 years, the medication has truly given us our life back.  He usually has attacks every six to eight weeks that last for approximately 3-4 weeks with anywhere from 2-5 attacks a day (I am not sure what you guys call them.)  During those times he always uses an injection (obviously WAY OVER the recommended dosage).

Now comes my concern, I have been a silent watcher on this board for several years and now I need some help.  My husband liver tests have come back very high and the doctor has told him that he has alcoholic liver disease, the problem is he is not a heavy drinker.  When I asked about the effects of long term imitrex injections she told me there could be no relation and pushed it aside? 

Can anyone help.

Thanks so much and I am happy to be here.

I am neither a doctor nor a medical field person so take this for what it's worth, I've never seen any postings relating imitrex use to this type liver problem. There are some doctors/very knowledgeable medical people who should be along shortly to give you some more input, that being said....

There is NO WAY imitrex should be his only line of defense. He should have some type of preventative, that's a medication you take while you are on cycle to reduce the intensity and frequency of your attacks. I use lithium, other popular prevents are topomax, verapamil, some combine the verapamil and lithium to get the desired relief.

Your first line abortive should be oxygen. Pure 02, using a non re breather mask, at a high flow rate, at least 15 LPM. Will abort an attack for me in as little as 6 minutes, that's COMPLETELY  pain free in 6 minutes. No limits on how often you can use it, no nasty side affects, MUCH cheaper then imitrex.

Get your hubby on this board, you will not find a more comprehensive collection of CH knowledge anywhere.

By the way, you are a saint for being a supporter. My wife has stuck with me thru 28 years of these damned things, I'd be lost without her.

Guiseppi

What else does he take???  As said above, most of us take a few meds for different reasons.  I look lithium and used O2 or Maxalt MLT or in last resort Zyprexa for abortives.  I have tried cafergot, topamax, verapomil, and melatonin.

What has he tried and what does he take?

I really can't recall of the medications that he has tried over the years.  I do know that currently when he starts an episode he takes a 7 day course of prednisone and topomax to abort the cycle, and imitrex to abort the headaches.  Homeopathically he has tried the water treatment as well as O2.

Im not a fan of topomax, but if it works, awesome.  Verapomil or even lithium should be fine to take.  Verapomil is a blood pressure med, I cant believe its classification would be a problem.

I do use hot showers or ice packs too.  Basically anything I can find, I'll try.

kepp us up to date adn keep asking questions and reading.

Headache. 2004 Feb;44(2):178-82. 

 
Frequent triptan use: observations on safety issues.

Robbins L.

Department of Neurology, Rush Medical College, Chicago, Ill. 60062, USA.

OBJECTIVE: To examine the safety of frequent triptan use over extended periods. For a small group of patients with refractory migraine plus chronic daily headache, triptans are effective. METHODS: This retrospective study primarily evaluated the cardiac safety of daily triptan use in 118 patients and, in addition, hematologic tests were assessed. Each patient had utilized a triptan for a minimum of 4 days per week for at least 6 months. Patients with rebound headache had been withdrawn from the triptans. Most patients (97 of 118) averaged 1 tablet daily; most would occasionally go for several days without a triptan. Forty patients had taken a triptan for 6 months to 2 years, 37 patients from 2 to 4 years, and 41 for 4 or more years. RESULTS: Routine hematologic tests were performed periodically on all patients, and no abnormalities were attributable to triptans. Almost all patients had an electrocardiogram, and no abnormal electrocardiograms were felt to be related to triptans. Cardiac echocardiography was performed in 57 patients. The 10 abnormal echocardiograms were not due to triptans. All 20 cardiac stress tests revealed normal findings. Adverse events were minimal; 9 patients described fatigue due to triptans, and 5 had mild chest tightness. CONCLUSION: This long-term study of 118 patients indicates that frequent triptan use may be relatively safe.

PMID: 14756859 [PubMed ]
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Funct Neurol. 2000 Jul-Sep;15(3):167-70.


Sumatriptan overuse in episodic cluster headache: lack of adverse events, rebound syndromes, drug dependence and tachyphylaxis.

Centonze V, Bassi A, Causarano V, Dalfino L, Cassiano MA, Centonze A, Fabbri L, Albano O.

Dept of Internal Medicine and Public Medicine, University of Bari, Italy.

This observational study was designed to examine the pattern of sumatriptan use in patients with cluster headache using more than the recommended daily dose of subcutaneously injected (s.c.) sumatriptan. Thirteen patients suffering from episodic cluster headache were asked to record the characteristics of their attacks and drug intake for 1 year. All reported a high daily frequency of attacks (more than 3 per day) and the related overuse of s.c. sumatriptan. The results show that the overall incidence of adverse events among patients receiving sumatriptan injections for the treatment of cluster headache is low. The extended administration of this drug in episodic cluster headache did not result in tolerance problems or tachyphylaxis. Only 4 patients experienced minor adverse events and recovered more slowly than the others. They suffered from migraine without aura and cluster headache, and showed a family history of migraine. Even though they must be viewed with caution, due to the observational nature of the study and the low number of patients included, these results suggest that the profile of sumatriptan may differ in cluster headache compared with migraine.

PMID: 11062845