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New CH.com Forum › Cluster Headache Help and Support › Medications, Treatments, Therapies › Amerge (naratriptan) Overuse?

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Amerge (naratriptan) Overuse? (Read 5008 times)

geosailor CH.com Newbie Offline I Love CH.com! Posts: 19 Gender:	Amerge (naratriptan) Overuse? Jul 23^rd, 2008 at 11:02pm Been taking amerge once a day for 6 days as I've been getting hit each nite. My druggist says this is too much as it can cause rebound headaches. Has anyone found this to be true? How frequent do you take it & for how long?
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Ray CH.com Alumnus Offline Ray Posts: 1996 Columbus, Ohio Gender:	Re: Amerge (naratriptan) Overuse? Reply #1 - Jul 24^th, 2008 at 2:49am I don't take Amerge any more, it's onset is too slow for my cluster headaches. It is recommended NOT to take daily, although for a maximum dosage (in healthy individuals) to take a maximum dose of 5 mg per 24 hour period. The dosages must be a minimum of 4 hours apart. Does this help? Ray
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DennisM1045

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Re: Amerge (naratriptan) Overuse?
Reply #2 - Jul 24^th, 2008 at 9:24am

Hi!

There have been documented cases where Amerge (Naratriptan) has been used as a preventive med.

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However you're drugest is right in being concerned. I've seen at least one person here on the board end up in rebound hell using this strategy.

Good luck...

-Dennis-

Where there is life, there is hope.
Where there is Oxygen, you must use proper caution.
So be safe, don't smoke while using O2. Kill the pain and not yourself.

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AlienSpaceGuy

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Re: Amerge (naratriptan) Overuse?
Reply #3 - Jul 24^th, 2008 at 8:39pm

A rebound headache can be caused by analgesics of any kind, from Aspirin to opiates. A rebound headache is similar to a tension headache. It is the head that hurts even if you take the analgesic against pain in another part of the body.

Triptans are not painkillers.

While painkillers act on the transmission of pain or its interpretation in the brain, the triptans interfere with the action that causes a cluster attack.

Hence, triptans cannot cause rebounds.

The myth about rebounds from triptans was probably spread by bean counters from insurance companies, in an attempt to justify the extremely low quota they allow.

And then, who wouldn't trade in a Kip 10 for a tension type headache?

For years I'm taking 20 mg of Relpax (Eletriptan) at bed time. It keeps the hits away for at least 6 hours, but usually for the whole night. If I occasionally get 3 hits a night, I don't blame it on the "overuse" of triptans. I never get any headaches that could be classified as rebound. Some years ago I used Amerge (Naratiptan) for the same purpose, with similar results.

Dennis, one person with bad experiences is no reason to to throw out the baby with the bath water.

Smiley

AlienSpaceGuy believes only in scientifically sound methods.

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geosailor

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Re: Amerge (naratriptan) Overuse?
Reply #4 - Jul 24^th, 2008 at 10:33pm

Thanks everyone for the feedback.

I found the following info on the mayoclinic website about rebound headaches, which I feel is useful for us CH'rs:

"Anyone who has a history of migraine headaches, tension-type headaches or other chronic headaches is at risk of developing rebound headaches from the overuse of pain relievers. Your risk increases if you use combination analgesics, ergotamine, or triptans 10 or more days a month or simple analgesics more than 15 days a month — especially if this regular use continues for three or more months.
Migraine medications. Various migraine medications have been linked with rebound headaches, including ergotamine (Ergomar, others) and triptans (Imitrex, Zomig, others). Interestingly, the ergot dihydroergotamine appears to have a lower potential for leading to this problem."

If you read the full article at the mayoclinic site then you'll see that rebound headaches are a serious problem and not a simple tension headache. I suspect that many of us have repeat CHs because of the rebound effect. We need to be careful in taking these drugs too frequently as I was. Now I have to endure the rebound withdrawls.

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DennisM1045

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Re: Amerge (naratriptan) Overuse?
Reply #5 - Jul 25^th, 2008 at 6:23am

AlienSpaceGuy wrote on Jul 24^th, 2008 at 8:39pm:

Hence, triptans cannot cause rebounds.

A technical point I concede. How about Medication Overuse Headache [MOH].

Quote:

Dennis, one person with bad experiences is no reason to to throw out the baby with the bath water.

I wasn't throwing this form of treatment out. I know several people here who use this approach. I was simply cautioning him that we are all different and he should understand that MOH is a possible outcome.

I could have been more complete in my advice Wink

Thanks for calling me out...

-Dennis-

Where there is life, there is hope.
Where there is Oxygen, you must use proper caution.
So be safe, don't smoke while using O2. Kill the pain and not yourself.

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geosailor CH.com Newbie Offline I Love CH.com! Posts: 19 Gender:	Re: Amerge (naratriptan) Overuse? Reply #6 - Jul 26^th, 2008 at 9:18am I don't see the difference between MOH & a reabound headache. The Mayo site clearly says that rebounds can be caused by triptans.
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