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coleenieb
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Advice on safety in pregnancy
« on: May 17th, 2006, 10:50am » |
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I'm new here so forgive me if its posted in the wrong section...
I need advice on hopefully finding treatments or medication that is safe to use on clusters while pregnant. I'm currently 23 weeks along and I was really hoping that I wouldn't get an attack - it seems CH's tend to fade during pregnancy - but I guess not for me. My current cycle started a few days ago. Before now my only course of action was ice packs, dark rooms, and lots of crying and swearing. oh and a jaunty eye patch.  I have also tried things like Max-alt and mushrooms - both with limited sucess. (and neither are safe while preg)
I also don't currently don't have a reg. doctor that I'm seeing - just an O.B. for my pregnancy. As much as I should find a reg doctor to help me out, its just impossable to really get anything done with CH's!
any advice would be greatly welcomed!
- Coleenie
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Bob_Johnson
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Re: Advice on safety in pregnancy
« Reply #1 on: May 17th, 2006, 10:56am » |
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A message I posted some time ago:
Re: Clusters and Pregnancy
« Reply #1 on: Oct 29th, 2004, 8:37am » Quote Modify Remove
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Issues about med effects are sufficiently complex and fluid that I would work closely with your ob doc and, ideally, with a headache specialist (acting as a consultant).
Given where you are in your pregnancy, you might print out this message and show to your doc.
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CNS Drugs. 2003;17(1):1-7. Related Articles, Links
Safety of sumatriptan in pregnancy: a review of the data so far.
Loder E.
Harvard Medical School, Boston, Massachusetts, USA. eloder@partners.org
The high prevalence of migraine in women during their reproductive years means that new drug treatments for migraine, such as the serotonin 5-HT(1B/1D) receptor agonists (the 'triptans'), are likely to be widely used by women of childbearing potential. Scrutiny of these agents in an effort to detect any signal of teratogenicity is thus important. A systematic review of the medical literature was conducted to identify information regarding the safety of sumatriptan during pregnancy. This agent was chosen to be investigated because it has been available for the longest and is the most widely used of the triptan class. Information was obtained regarding the impact of migraine on pregnancy outcome, and data on sumatriptan use in pregnancy were obtained from animal studies, preclinical drug trials, postmarketing surveillance efforts, prospective pregnancy registries, national birth registries and teratogen information services. Synthesis of information from these sources is sufficient to rule out a large increase in birth defects from sumatriptan use during pregnancy and is reassuring for cases where inadvertent exposure to sumatriptan during pregnancy has occurred. However, current information is not sufficient to rule out small increases in the risk for birth defects. For this reason, caution should be exercised in making a positive recommendation for the use of sumatriptan during pregnancy.
Publication Types:
Review
Review, Tutorial
PMID: 12467489 [PubMed - indexed for MEDLINE]
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I checked drug info on medscape.com and it's o.k. for limited use in pregnancy.
1: Headache 2001 Sep;41(:813-6
Olanzapine as an Abortive Agent for Cluster Headache.
Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.
OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. The initial olanzapine dose was 5 mg, and the dose was increased to 10 mg if there was no pain relief. The dosage was decreased to 2.5 mg if the 5-mg dose was effective but caused adverse effects. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and two patients became headache-free after taking the drug. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. It alleviates pain quickly and has a consistent response across multiple treated attacks. It appears to work in both episodic and chronic cluster headache.
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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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OTC meds are not very helpful with cluster, as you know, but may be one of the few options available to you. Some folks have good luch aborting/easing an attack by applying an ice pack to the pain site. Others find very hot water also works; others have used a hair dryer blasting the pain site works! No predicting; just try.
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Bob Johnson
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nani
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Re: Advice on safety in pregnancy
« Reply #2 on: May 17th, 2006, 11:08am » |
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Hi Coleen...welcome, and sorry you had to find us.
The safest treatment during pregnancy is oxygen. Have a look on the left at the oxygen info link. Print it out and take it to your dr. It has to be high flow (10 - 15 lpm) pure oxygen, with a non-rebreather mask. Have a look at the clustermasx, too. It gets rave reviews.
www.clustermasx.com
pain free wishes, nani
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Melissa
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Re: Advice on safety in pregnancy
« Reply #3 on: May 17th, 2006, 12:21pm » |
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An obgyn can also prescribe O2, as mine was willing to do it for me 2 & 1/2 weeks after I had my son and went into cycle. I don't see where it would hurt to ask if yours could do it also.
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lionsound
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Re: Advice on safety in pregnancy
« Reply #4 on: May 17th, 2006, 2:26pm » |
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Hello Coleenie,
I know how hard this is for you  ....My four month old is napping as I type this....
When i was recently pregnant the best thing I could use was OXYGEN and as I am nursing, it still is.
I was also allowed LIMITED tylenol with codeine (which I maybe used twice and only well into my second trimester) with my doctor's permission. I had an OB/GYN and a headache specialist. I had to carefully weigh the risks vs. benfits...exhausted and not eating was not good for me or baby.
We are not doctors here...you need to ask yours what is best for you...Talk to your OB and ask her to consult a neurologist or a Headache specialist on your behalf if you can't get to one yourself. You and your baby are worth it! you can do this.
PM me if you want to chat more....support is the best medicine...
be wel and PF,
lionsound
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| « Last Edit: May 17th, 2006, 2:29pm by lionsound » |
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coleenieb
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Re: Advice on safety in pregnancy
« Reply #5 on: May 17th, 2006, 3:49pm » |
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thank you so much for all the advice. I know I need to get the ball rolling and start calling some doctors and my OB about it, but honestly with the headaches and the typical pregnancy brain fog I'm just amazed I'm still functioning at all! the idea of trying to talk, let alone get a very important point across to a doctor or nurse on the phone scares me.
the greatest thing so far is knowing I'm not alone in this
- Coleenie
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lionsound
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Re: Advice on safety in pregnancy
« Reply #6 on: May 17th, 2006, 9:47pm » |
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It's a good idea to print out the oxygen info and anything else you find useful and bring it with you to the doctor's office or keep it handy near the phone so when they return your call you are ready. You can even print this thread of replies if that helps you. I find it useful to have a list of questions and check them off as I get them answered and write notes on the replies...not leaving without getting everything checked off.
you're right..you are not alone!
-lionsound
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