You have an unusual picture but, in light of this report, not entirely out of the question for you.

Have no alternative but to work with the doc, considering dropping Imitrex and use another triptan and see what happens.
----
Headache. 2004 Jul;44(7):713-8.   

 
Subcutaneous sumatriptan induces changes in frequency pattern in cluster headache patients.

Rossi P, Lorenzo GD, Formisano R, Buzzi MG.

Objectives.-To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature. Background.-Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial. Methods.-Six CH sum-naive patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described. Results.-All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. IN ALL PATIENTS, THE CH RETURNED TO ITS USUAL FREQUENCY WITHIN A FEW DAYS AFTER SQ SUM WAS WITHDRAWN OR REPLACED WITH OTHER DRUGS. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache.

CONCLUSIONS.-PHYSICIANS SHOULD RECOGNIZE THE POSSIBILITY THAT TREATMENT OF CH WITH SQ SUM MAY BE ASSOCIATED WITH AN INCREASED FREQUENCY OF HEADACHE ATTACKS.

PMID: 15209695 [PubMed]

{Note from BJ: Review of PubMed in 1/11 found no citations with this type of data in the last 10-years. The absence of newer reports suggests that experience of recent date is not stimulating much attention on this topic. In view of this reports comments about quick return to the former headache pattern, it appears such changes in frequency is not a significant issue.}

The nasel sprays take a bit longer to work than the injections but I've always used them because they are more convenient, especially when you are not at home.

ANY of the Triptans will and DO cause rebound headaches.  That is why we always tell folks to only use them in dire circumstances.

Re.#4: Linda and I will split a hair on this question. Triptans CAN & MAY lead to changes in the headache experience but there is no evidence, that I can find, which supports the idea that they DO (implying a universal/very common response).

Review of the last 15+ years of literature on side effects with sumatriptan show a very uneven picture but clearly no general evidence of a broadly based pattern of negative side effects. The abstract I posted, above, is a fair representation of the literature: possible side effects which, not common, and easily resolved with a change of meds. In my judgment, I don't see any evidence to avoid sumatriptan, given it's excellent record of effectiveness and safety. The exception, of course, is if you have a response which leads to considering a change.

With any med, for any condition, we are always trying to balance the benefits against the side effects. Or, use it until your PERSONAL experience says it's not helpful for YOUR body.

Thank you for the responses. I do have oxygen tanks and have used it as an abortive, but will minimal success. Although, I recently discovered my lack of success may be due to the fact my doctor set me up with a regulator that maxes out at 8 LPM and the wrong type of mask. I'm going to work on getting a proper regulator and mask and hope for better results. Can't wait for spring to be over...

ddorz wrote on Apr 26^th, 2012 at 1:41pm:



You will be AMAZED at how fast and COMPLETELY you can abort an attack at the higher flow rates. 15 LPM is considered the rock bottom flow rate for most CH'ers, with some finding NO relief at 15 LPM, but aborting their attacks in minutes at 25 LPM. Start HIGH on the flow rates, then back off until it doesn't work as fast. That'll give you a good idea of what you need.

Joe

I'm sure you'll appreciate the difference that a flow rate of 25lpm makes. I know that for killing off my CHs that 25lpm is over twice as quick as 15lpm, so that means I've avoided a whole lot of pain multiple times.

That's a common problem, seems the few docs who DO know about 02 prescribe it at 8 LPM. A few, like Jimi, could abort at rates that low. Most require at least 15 and find at higher flow rates the aborts are faster. I use a demand valve, similar to what a SCUBA set up looks like so it's unlimited flow. My aborts run 6-8 minutes with that set up. It's actually hard work to totally hyper-ventilate...almost tiring...but the first time you knock beast on his butt in under 8 minutes you'll see why we all push it so hard. Hope it does it for you too.

Joe

My personal experience with Imitrex injections is very clear:  There is a "pee in your pants to keep warm" effect. Both frequency and strength of attacks gets higher. I don't know what is true for others.

An abortive treatment plan would give due consideration for the most effective least invasive abortive first.
1:  02
2: vascular or cardio stimulation eg; exercise,showers, cold air therapy, cold water consumtion.ect,ect and  02
3: 02+caffeine
and last
4:pharmacuticals or triptans of any sort.
Key word: treatment plan
but thats just me, not suggesting anything to anyone.
tachead

Er, I meant 2-3 minutes later.  I sure WISH the trex worked that fast!   

Great news with the oxygen, now you see why we suggest people go to 25lpm as the abort times drop which means much less paind.

For the imitrex it sounds like it could be rebounds were affecting you.

I can verify that about 30 seconds after Imitrex injection my headache shoots from 4-5 pain to 8-9, and this will last between 7-12 minutes.  After that, the pain will drop to 0 in a matter of 20 seconds.  If I do not inject, I'm stuck with 4-7 pain intensity for 1-2 hours.  I reluctantly prefer the 10 minutes of 8-9 level pain.  But I sure wish O2 would've worked for me...