Thanks for bringing this to our attention, Bob.

I just visited a HA specialist this week.   He was insistent that Sumatriptan only causes rebounds in migraine.   I'm not sure which to believe.

Something to look into.

Jeannie

Jeannie: In medicine it is uncommon to have absolutes guiding our choices. Your doc is voicing a view which has softened some but it is--my concern here--wrong to present an absolute--yes/no--on this issue. Individual variation is so very common in how medications affect the individual body.

This problem appears here all to frequently when you read someone write: "I refuse to use XXX because I've read the side effects and I won't risk ....." What the average reader does not understand is that side effects must be presented but what is so often missing is data on the FREQUENCY that any one appears. If you go to the Physicians Desk Reference, you find that the rate may be from 1/2% and up.

Bottom line: we are always making decisions based on benefit vs. risk--whether in medicine to driving to the store. The issue is that most people don't think in these terms; they too often live in terms of absolutes--good/bad; safe/dangerous; moral/immoral, etc..
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And then another confounding variable.....

Rebound headaches. "Rebound Headaches--A Review", Au. John S. Warner, M.D., in HEADACHE QUARTERLY, 10:3(1999). (There is some confusion on the board about the meaning of "rebound". There appears to be an emerging consensus in the medical literature to define "rebound" as a headache which is caused by the overuse of any medication used to abort a headache or relieve pain. "Recurrence" [of a headache] is being used to refer to the redevelopment of an attack when its "normal" duration is longer than the useful life of the medication which has been taken. That is, the medication effectiveness is reducing before the headache has come to an end; the pain redevelops.)
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Sumatriptan has a hard initial punch and relatively short effective life--a combination which works well for most Cluster attacks. However, some people, whose Clusters have a longer life, find that the med is wearing down even as the pain continues. One can understand how this sequence comes into one's thinking: Attack, Imitrex injection, pain continues, it's a rebound cluster which has developed from the Imitrex.

This is one of the reasons that several other triptans were developed having less initial punch but longer effective life. While aimed at the migraine crowd, at first, a number of cluster users have found this characteristic of value to them.

Joni wrote on Dec 12^th, 2009 at 2:12pm:


What kind of prevent?  A taper seems to mean pred. 

Brew wrote on Dec 12^th, 2009 at 10:20am:
 

I've been thinking about this a lot today.

It really does seem like the more I use the more often and severely I get hit later.   

Jeannie

Oops, that should have said 8 weeks (my cycle)...typed the wrong #.

Joni,

Coming off of the Verap is very difficult for me.  Every time I try to wean off of it ( in the past) I  experience strong shadows.  My doc wants me to stay on it for at least six months after my cycle ends.  This, however, puts me right back at a new scheduled cycle so, if I choose to continue with this treatment I may be on the Verap continuously.  I am still looking a seeds to act as my prevent once I kick this cycle.

Jeannie

Jeannie wrote on Dec 14^th, 2009 at 9:23am:


Thanks Jeannie!!!  I was needing to hear that, but I am sorry it runs into your next cycle.  Between my last 2 cycles (a year apart), I had it down to 10mg per day, but if I forgot it, I got that funny felling again...I guess you could say very mild shadows....just enough to worry me.  I cannot say id I stopped it then or now, that I would have a full blown cycle.  I really don't THINK I would but am too afraid to find out.  Have you ever stopped it?

My 2cents just in case it matters.

Before I found Imitrex. I had a typical 10 week cycle that resembled an upside down V. I would start out getting 1 a week, and ramp up to about 5 a week and then ramp back down. My CH's would typically last about 1 1/2 hours from start to end. After being prescribed Imitrex, My CH's would start out at 1 per week but would quickly ramp up to about 20 per week. At 1st I couldnt put my finger on it, but I did notice that if I just rode out the CH, then I'd get a break before the next 1. BUT, If I took a Imitrex, I would within 4-8 hours get another CH. My rebound CH's typically ranged in the 8-10 Kip scale. My non-rebounds typically ranged in the 5-9 range.
Dont get me wrong..... Imitrex can be a real lifesaver when out of the house, or when attending functions. But for myself, It was almost like I was just staving it off for a later time.
When my cycle starts now, I go straight to my Neuro and get the Prednisone taper with the Verapamil. So far that works everytime for me.

Happy Holidays,
                        Patrick_A