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Topic: IMIGRAN INFORMATION PLEA. (Read 634 times) |
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JoeKen
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IMIGRAN INFORMATION PLEA.
« on: Oct 12th, 2007, 12:13pm » |
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 Hi,
I wonder if anyone out there in Clusterland can offer me any information on the possible side effects of Triptans. I am a 67 year old male, resident in the UK, who now realises that his first CH attack episode was over 50 years ago but nobody then had a name for it. I never had another attack until I was approaching 60, when I started being episodic. In the intervening period I suffered from Migraine HAs from time to time.
When CH was finally diagnosed about 5 years ago I was eventually prescribed 10mg tablets of Sumatriptan, up to 2 tabs per day, (later replaced by the same measure of Almotriptan - for Health Service budget reasons!!), and high flow rate oxygen. To be fair, this combination has worked very well but in the last year or so I have gone from Episodic to Chronic. This has resulted in me taking up to 20mg Almotriptan per day for around 5 days eack week, say around 80mg Almotriptan each week on average, accompanied by oxygen as needed, to keep the beast at bay.
A week ago today I had a Transient Ischaemic Attack (aka TIA or mini-stroke) in the early hours of the morning. I was hospitalised and tested (Cat Scan and Carotid Doppler) and no cause for concern was found. The Consultant Stroke Surgeon has made me an appointment at his Out-Patients clinic and discharged me from hospital. He expects the appointment to be in about 6 weeks time, in the meantime he is to write to the local Neurologist who diagnosed my CH several years ago (different hospital) to ask him if the Triptans that I was taking could have contibuted to my TIA as he could find no other cause.
And now the plea: -
has anyone out there had, or heard of, any similar incidents that might be useful to the Stroke Surgeon, as my lifestyle and test results tick all the right boxes for NOT having a TIA.
Any feedback at all would be appreciated and sorry it took so long to post.
JoeKen.
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Not sure I should be here, but it's as near as I'm going to get to finding out what is the correct name for my condition. Usually KIP 5 or below but last up to 16 hours and always one-sided, behind the eye, usually right but ocassionally left.
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Bob_Johnson
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Re: IMIGRAN INFORMATION PLEA.
« Reply #1 on: Oct 12th, 2007, 2:41pm » |
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Most difficult question for I've seen nothing in my searches which directly address the question. In the abstract, triptans have been safe but your situation is not yet resolved as to what has actually occurred. That being said, I'd be looking for alternative treatments for chronic. Sending along one abstract which refers to lithium--long used for Chronic.
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J Headache Pain. 2005 Oct;6(5):417-9. Epub 2005 Aug 1.
Warfarin as a therapeutic option in the control of chronic cluster headache: a report of three cases.
Kowacs PA, Piovesan EJ, de Campos RW, Lange MC, Zetola VF, Werneck LC.
Headache Section, Neurology Division, Internal Medicine Department, Hospital de Clinicas, Universidade Federal do Parana, Rua General Carneiro 181/1236, 80060-900 Curitiba, Brazil. cefaleia@hc.ufpr.br
Chronic cluster headache remains refractory to medical therapy in at least 30% of those who suffer from this condition. The lack of alternative medical therapies that are as effective as, or more effective than, lithium carbonate makes new therapies necessary for this highly disabling condition. Based on a previous report, we gave oral anticoagulants to three patients with chronic cluster headache. Two of them remained cluster headache-free while taking warfarin. In the third patient, the use of warfarin for three weeks initially increased the frequency and intensity of cluster headache attacks but subsequently induced a prolonged remission. In spite of the paucity of data available, oral anticoagulation appears to be a promising therapy for chronic cluster headache.
PMID: 16362716
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Suggest your doc get in touch with: the Institute of Neurology, London, as one of the best headache outfits near you.
http://www.ion.ucl.ac.uk/
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Bob Johnson
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JoeKen
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Re: IMIGRAN INFORMATION PLEA.
« Reply #2 on: Oct 12th, 2007, 3:44pm » |
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Hi Bob ,
Thanks for your input. The first of several meds the hospital put me on was 40mg Verapamil to lower BP and thin my blood. My highest BP in all the many times it was taken in hospital (I was shunted round 3 departments in the first 24 hours, each needing to do their own tests), was 146/104. No one I asked said that they also knew of it's use as a preventative treatment for CH. My wife is on Warfarin to thin her blood as she has AF, so I am aware that both Verapamil and Warfarin have blood thinning (anticoagulant) effects.
On discharge my medication was increased to 40mg Verapamil twice per day and 1 x 75mg soluble aspirin (I also suffer from "mild chronic gastritis" thought to have been brought about by my high consumption of Anadin Extra tabs before CH was diagnosed), and 40 mg Omeprazole and 1 x 40mg Simvastatin ('cos my Cholesterol was just under 6). Much to my surprise the CH now seems to be being held off by this regime, as 80mg of Verapamil seems almost inconsequential from reading various posts on this site. I guess that it is very early days yet but let's hope that it lasts.
Anyway, thanks agai for the pointer to the web site.
JoeKen.
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IP Logged |
Not sure I should be here, but it's as near as I'm going to get to finding out what is the correct name for my condition. Usually KIP 5 or below but last up to 16 hours and always one-sided, behind the eye, usually right but ocassionally left.
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michael
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Re: IMIGRAN INFORMATION PLEA.
« Reply #3 on: Oct 12th, 2007, 4:14pm » |
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Hi JoeKen,
I am 54 years old and have been using imigran injections almost exclusively over the past 8 years. (Been a sufferer for 40 years).
Not had any major poblems but I have found that the number of attacks has increased dramatically when in cycle and I now get heavy shadowing in between cycles that I use Imigran Radis 100mg tablets to abort.
Although my neoro says not, my doctor and pharmasist both agree with me that the heavy use of triptans do cause rebound headaches.
Not sure this helps with your question.
Mike
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DennisM1045
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Re: IMIGRAN INFORMATION PLEA.
« Reply #4 on: Oct 13th, 2007, 11:16am » |
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Hi JoeKen,
Sorry to hear about your TIA. Getting your bp in line sounds like the hightest priority. How is it now?
Like most things CH related, what works for one may or may not work for another. The fact that you seem to be getting some relief from such a low dose of Verapamil seems to be more proof of our collective experience; one size doesn't fit all. I'd just be thankful and enjoy the break. I hope it continues for a long time.
-Dennis-
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JoeKen
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Re: IMIGRAN INFORMATION PLEA.
« Reply #5 on: Oct 13th, 2007, 12:32pm » |
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Hi Dennis ,
Thanks for the good wishes. The BP is varying between 135/145 over 65/85 (apart from immediately after the TIA when the second figure reached 104 - not surprising!!). In other words it isn't particularly high and never has been. My profile ticks most of the boxes for NOT having a TIA - normal BP, not smoked for 50 years, neglible alcohol intake (CH trigger), cholesterol between 6 and 7, fairly active, fairly good health apart from CH and mild chronic gastritis, and I try to eat a varied diet. After my Carotid Doppler the Consultant said that "It showed absolutely no narrowing of the Carotid arteries, which is most unusual in a man of my age", so where has the TIA come from??
Anyway the CH over the last couple of days has begun to re-assert itself - KIP 2 to 3, could live with it, but 20 mins of oxygen sees it off let's hope it gets no worse.
JoeKen.
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IP Logged |
Not sure I should be here, but it's as near as I'm going to get to finding out what is the correct name for my condition. Usually KIP 5 or below but last up to 16 hours and always one-sided, behind the eye, usually right but ocassionally left.
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nani
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Re: IMIGRAN INFORMATION PLEA.
« Reply #6 on: Oct 13th, 2007, 12:33pm » |
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Hi JoeKen. I've been unable to use any triptans because of blood pressure and heart issues, and a previous ruptured brain aneurysm. The vasoconstrictive properties are dangerous, for me.
There are other abortive options that are safer in this situation. Oxygen, olanzapine, and alternatives like energy drinks may be worth trying.
Good luck. pain free wishes, nani
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JoeKen
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Re: IMIGRAN INFORMATION PLEA.
« Reply #7 on: Oct 13th, 2007, 2:40pm » |
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Good Morning Nani,
Thanks for your input. Sorry to hear about your complications - as if CH isn't bad enough on it's own!!!
I am currently on oxygen, (have been for a couple of years now), and it was very effective in 9 HAs out of 10 when used in conjunction with Triptan tabs. Now Triptan is out I am using oxygen alone as an abortive but using 40mg Verapamil tabs twice a day as preventative. I have been on this regime for only 3 days after coming out of hospital so it's a bit early to be sure but KIP 2 to 3 is the worst it's been in these 3 days and oxygen blows it away - so far, so good!!
I am not familiar with olanzapine - maybe it is only available in the USA. I started using energy drinks (Relentless, contains 160mg cafeine per can) about 3 weeks ago and I am trying hard not to link it with the TIA - in the absence of the usual candidates for causes I am clutching at straws!! - so I plan to stay away from energy drinks for a while. 
Thanks again,
PFDAN and MOT (many of them).
JoeKen.
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IP Logged |
Not sure I should be here, but it's as near as I'm going to get to finding out what is the correct name for my condition. Usually KIP 5 or below but last up to 16 hours and always one-sided, behind the eye, usually right but ocassionally left.
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Karla
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Re: IMIGRAN INFORMATION PLEA.
« Reply #8 on: Oct 13th, 2007, 3:45pm » |
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Most people around here take up to 960mg of verapamil to completly keep the ch away. The fact that you are having limited sucess at such a low dose is great news. I would try increasing it to a higher dose and see what happens then. Another name for olanzapine is zyprexa. It is commonly used as an antiphycotic for treatment in schizophrenia. It has however, shown promising results in ch. Good luck!
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Karla
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JoeKen
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Re: IMIGRAN INFORMATION PLEA.
« Reply #9 on: Oct 13th, 2007, 6:00pm » |
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Hi Karla ,
Thanks for your input and encouragement. At the moment I am in a difficult position regarding my medication. Having just been discharged from hospital after a TIA my current medication is being prescribed by the 'Stroke' consultant. He admits that his knowledge of CH is limited and has undertaken to liase with the Neuro who diagnosed my CH. This process is expected to take around 6 weeks, which is when I have my outpatient appointment with the 'Stroke' consultant. On discharge the 'Stroke' consultant prescribed my medication for the intervening period. I have enough Verapamil to last me the 6 weeks at 2 x 40mg per day, plus soluble Aspirin tabs and anti-statin tabs to last me for 2 weeks at the prescribed dosage (you explain it!!!) .
My plan is to talk to my GP about further aspirin and anti-statin medication but the medical hierarchy over here is such that the GP would not normally change a Consultant's medication. The best thing that I can hope for is for the GP to give me a prescription in accordance with the Consultant's dosage to last me until after I have seen the Consultant in the out-patient's clinic. Only after the Consultant confirms that he no longer needs to see me would the GP again take up responsibility for prescribing/amending any medication for me. In short, my ability to up the Verapamil dosage is limited, but I would try via my GP if the current Verapamil dose began to fail.
Sorry for the long screed but sometimes other people find it interesting to hear how the system works in other countries.
By the way I think that I have seen a recent posting on this Message Board about a new (but small) survey linking very high Verapamil usage with heart disease, so I'm currently in no hurry to up my Verapamil intake unless it is absolutely necessary.
Take care,
JoeKen
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IP Logged |
Not sure I should be here, but it's as near as I'm going to get to finding out what is the correct name for my condition. Usually KIP 5 or below but last up to 16 hours and always one-sided, behind the eye, usually right but ocassionally left.
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