Rizatriptan, Tricyclics...

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Posted by Francois ( on February 06, 2000 at 23:58:25:

In Reply to: Suggestions on Daily Preventatives posted by Amy on February 06, 2000 at 22:03:16:

Hi Amy,

I have had CHs for 35 years (since age 11). In that time, there are few drug protocals I haven't tried. But I must say, I have not heard of rizatriptan (Maxalt) before, so I looked it up.

The clinical pharmacology on rizatriptan states up front that it is "a migraine drug," and that "it is not suitable for all migraine attacks or those that involve only one side of your head" - that is, not for cluster headaches. Of course, if it works for your CHs, terrific!

If the only reason you aren't continuing with amitriptyline is because you might gain a few pounds, get over it. Your partner will still find you attractive if you are a size 7 or a size 9 (or whatever). Increase your activity level and eat less, and your shape will stay fine.

Amitriptyline (Elavil) was one of the first tricyclics ever produced. The worst side effect for me was sedation. I could (and did) sleep 20 hours per day taking this stuff. But it was the first drug that I ever took that made a real dent in my CHs.

Since the 60's, when amitriptyline came out, much research and many new products have come out of the tricyclic drug class. Most notably, these are doxepin (Sinequan), desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Pamelor). Nortriptyline, I believe, is the purest form to date, and has least side effects. (The dosage is exactly 1/2 of that for imipramine.) This is what I take daily.

I won't go on, every person responds differently to any medication. This is simply food for thought.

Speaking of food, here's another tip...cut out as much salt as possible out of your diet...Margi, who posts here regularly, has a water routine that she and others believe in. Some people swear that diuretics help their heads. Others take the drug lithium carbonate. All three of these are driving at essentially the same thing, which is to reduce sodium (salt) in the system. (Water flushes sodium out, diruretics push sodium out, and lithium replaces sodium so it is not absorbed.) So, say goodbye to snack foods, Campbell's Soup, and McDonalds french fries, then get serious about no salt.

Good luck.

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