so the cycle is in full mfing swing and i find myself popping like up to 4 pills a day along with the o2 can this cause rebounds? or is it really bad? i still have at least 1 monster everyday it seems

Hi Finn,

Imitrex is a Godsend and a curse!  When I just can't stand the pain I rely on an injection or pill (if that's all I have).   It always works for me.  The curse is that I'm sure it causes rebounds for me.  The more I use the longer my cycle and the harder I get hit.

Pain free vibes to you

Jeannie

Just reviewed the literature on PubMed on this topic and find almost nothing of note since 2000.
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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  
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The common position re. rebound here is that it occurs. Medical literature is unclear; I don't see consensus beyond "it can occur."

Finn,

You might want to consider energy drinks with 1000mg Taurine and caffeine.  Somewhere else on these boards I learned about them and they help with shadows and low-Kip attacks.  I drink Rock Star Light because I actually like the taste and it is low-cal, however Red Bull works, too.  Actually, these are also really useful when out and away from other abortives! 

I use Imitrix injections for those wake up in too much pain hits in the middle of the night.  I use O2 when home the other times. I found that pills do nothing, probably because I have learned in 18 years of these events, that I need to ACT within 5 minutes or the beast wins this bout.  I used to use Maxalt MLTs and they worked, but no longer. 

I am also on Verapamil (480mgs and tapering soon!); are you on a prophylactic med? 

BTW, what I got from the article is that it is a small study, and about one third of the participants had some minor issues from using the Imitrix injections. 

May you be PF...

back from the doc yesterday and it went pretty much as i thought
,, he prescribed verapamil and some injections which he said was "intense" which kinda made me laugh as i would prolly run a ice pick thru my brain if i thought it woudl cure me, the funny thing is i didnt have time to fill the prescription and last night i had a hit free night and as sure as im knocking on my desk i havnt had a hit today either, so lets hope the cycle is waning, but to be honest im likeing the 02 im not sure i even want to take 2 pills a day for 3 months

yeah man thanks so much i love that ish,, also another funny note, i asked him if he had any other clusterheads and he said yes "thier all the same, 40ish men who only see me every 2 or 3 years and are always in a horrible way when they do" i laughed and said welli really dont want to come here ya know.. i also told him that the 02 is THE BOMB

i still havnt started the verapamil and ive missed the o2 twice and got slammed (both times ran out and didnt have another tankhandy) when i get smashed it effects me for 2 days wherein i basicly have anon stop headache that i can only keep at bay with o2 and imitrex if for any reason i were to miss the o2 or a pill i would be slammed,, i picked up the injectors and i was able to nullify a bad one, when i feel a hit coming i use the oxy and sometimes take a pill and the shadow goes away and i dotn get hit,,, the pills only work for me when i feel a strong shadow that i know is a hit waiting,, sometimes i guess it might not hit but as long as the pills arnt harmfull then i just take one

The reason why imitrex works best via injection (from what I understand) is that an injection puts the medicine right into your blood stream. A pill needs to be processed and dissolved in the stomach then it reaches the blood stream. By this point, it may not be as potent (in fact up to 40% less potent) as opposed to injecting the medicine directly into the blood stream.

This is why pain pills do not work for us.