Bob Johnson
CH.com Alumnus
 
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"Only the educated are free." -Epictetus
Posts: 5965
Kennett Square, PA (USA)
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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 =============== I knew a man in N.C. who died at 75 never having a water heater in his house. Why? Because his grandmother's heater exploded (when he was a young kid) and he never trusted them again.
The second leading cause of cancer deaths in men is prostate cancer, although it's quite curable when men allow themselves to be diagnosed and treated.
My point is this: decisions about medical treatments are fraught with human issues and technical/medical considerations which make easy and simple decisions--which are also judicious decisions--increasingly difficult.
As the number of meds & treatments have multiplied and become more potent and effective, the more side effects we have to be aware of and learn how to manage--if we want the benefits they offer. It's simply an illusion to expect high levels of both effectiveness and freedom from side effects: it's just not in the cards. (More than one science type has commented that aspirin would never pass the FDA licensing process were is coming out today: too many side effects.)
I have the perspective of age to remember when major surgery was used to treat infections because antibiotics didn't arrive until I was just getting out of grammar school! Perspective is hard to develop and especially so when dealing with a complex area out of our common experience, e.g., medicine. We do have some good sources of information which only became readily to hand with the advent of the WWW. BUT even these resources can be a problem when we don't know the quality of the information or have the skills/experience to interpret what we find.
Over the years of reading messages here I've often been anxious about the readiness of folks to manipulate drug doses, play with combinations of meds, and not reporting problems to their docs--and blow off a med as bad/useless. Even the most conscientious consumer will have some problems; the ignorant and flippant are setting themselves up for trouble.
In the end, we are all confronted with trying to strike a balance between benefit and potential cost (cost being $, side effects, and degree of effectiveness). But I'm not about to give up on modern medicine because half a life time ago the picture was so limited and even grim!
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