Use of Imitrex to stop rebounds

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Posted by Bob P ( on December 14, 2001 at 11:39:27:

In Reply to: Response to overuse of some headache meds posted by Bob Johnson on December 14, 2001 at 10:39:42:

Oral sumatriptan useful during detoxification for rebound headache Nov 24, 1998 (Reuters Health)

Daily oral sumatriptan can be used during the withdrawal period in patients with rebound headache who are being detoxified, according to researchers at the University of Washington School of Medicine in Seattle.

If pain medications are overused, episodic migraine can be transformed into chronic daily headache, Dr. Stewart Tepper and Peggy Drucker explain in the October issue of Headache. To remedy this, patients are often hospitalized and administered intravenous dihydroergotamine (DHE) while all rebound-related drugs are withdrawn.

In the current study, the researchers investigated whether oral sumatriptan treatment could be used in the same way in an outpatient setting. The subjects included 26 patients who had met International Headache Society criteria for episodic migraine but who, at baseline, had more than 15 days of headache per month for longer than 1 month.

Treatment during withdrawal of rebound-related drugs included 25 mg oral sumatriptan three times daily for 10 days, or until headache had remitted for 24 hours.

The investigators found that at after 1 month, 58% of the subjects returned to an episodic migraine pattern, and after 6 months, 69% no longer experienced chronic daily headache. The results of subjective patient reports indicated that only two subjects did not believe that "...sumatriptan provided a helpful bridge during the acute withdrawal period."

Based on these findings, the researchers suggest that "[o]utpatient oral sumatriptan detoxification for medication-habituated patients may offer an alternative to the now traditional Raskin inpatient DHE protocol."

Headache 1998;38:687-690.

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