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Posted by Lawrence Robbins M.D. ( on March 28, 2000 at 20:22:01:

Of course, Imitrex injections have been the most effective BUT.....we have also used the other forms for many people with clusters, particularly for those with longer clusters, and for those people who do not want to use an injection, can't afford it, or get intolerable side effects, or have too many cardiac risk factors...
The other forms include Imtrex tabs/nasal spray, Amerg, Maxalt, and Zomig...each has their place and role
Imitrex nasal works fairly quickly(but not nearly as fast as injections) but is relatively mild...the tabs take longer, but have reasonable efficacy.
Amerge has a long, slow onset of action, aand is mile(the milder, kinder, gentler triptan)...but is useful as a preventive in certain circumstances...
Maxalt MLT is a good product, relatively short acting like Imitrex, but useful for those with nausea(the MLT form is put on the tongue)...good efficacy, low side effects...probably not as effective as Imitrex tabs, but less side effects.....
Zomig has good efficacy but more nausea......
Lawrence Robbins M.D. author of Management of Headache and Headache Medications(Feb.2000) and Headache Help(for pts, 2nd edition out in June 2000)...

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