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Topic: Fresh Research - Imitrex Increases Headaches (Read 1111 times) |
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floridian
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Fresh Research - Imitrex Increases Headaches
« on: Jun 25th, 2004, 8:44am » |
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Lots of people here have claimed that sumatriptan (imitrex) prolongs a cycle or makes headaches more frequent, in spite of the fact that it provides quick relief on a headache by headache basis. This research suggests those people are right. Maybe trex doesn't abort a headache - it just postpones it.
Quote:Headache. 2004 Jul;44(7):713-8.
Subcutaneous sumatriptan induces changes in frequency pattern in cluster headache patients.
Rossi P, Lorenzo GD, Formisano R, Buzzi MG.
Objectives.-To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature. Background.-Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial. Methods.-Six CH sum-naive patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described. Results.-All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. In all patients, the CH returned to its usual frequency within a few days after SQ sum was withdrawn or replaced with other drugs. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache. Conclusions.-Physicians should recognize the possibility that treatment of CH with SQ sum may be associated with an increased frequency of headache attacks. |
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| « Last Edit: Jun 25th, 2004, 9:02am by floridian » |
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Kevin_M
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #1 on: Jun 25th, 2004, 9:28am » |
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That pretty much has been true with me Flord. Prior to finding a good preventive and without having oxygen, I used imitrex a lot. Last two episodes were the worst with frequency and their length. Last one stayed almost eight months, three hits a night, same or more during the day.
When I got a new doctor, she added oxygen, pred taper and verapamil for the first time. I was able to use the trex more sparingly and it took me out of the last cycle.
Perhaps use of trex, because it is effective, but more sparingly may not affect a cycle as much but I was using about six a day/night for months.
I had thought that this study would have this outcome, from my experience and from my new doctor that had thought it too. On my first visit with her I wrote down the meds I was taking and the frequency. A correlation could easily be plotted just from that data. Before I saw her, the last bout was going strong still after six months. The apex kinda...stayed.
Quote:| Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache. Conclusions.- |
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So, I would certainly believe that with trex as the only medication for treatment, which it was with me, and a prevent which was useless, is not the way I would treat it again. Who knows how long it may have lasted.
Kevin M
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| « Last Edit: Jun 25th, 2004, 2:04pm by Kevin_M » |
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ozzman
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #2 on: Jun 25th, 2004, 9:29am » |
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Interesting research with many implications. For the longest time I used to argue the opposite, from previous research. Even though the population sample seems small, anecdotal evidence around this place seems to validate the findings.
The problem is the weaning off. Once you taste PF, how can you possibly go through one attack withou the Trex nectar?
It sucks, but it is doable.
Ozzy
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peter K
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #3 on: Jun 25th, 2004, 9:59am » |
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What is over use of imitrex? My cycles last 2-3 months. My 8th year w/CH.(480mg of Verp and 100 mg of topamax) I am in 2 months and 10 days now. The HA gets me at 7pm to 9pm then I kill it with the nasal spray then all of a sudden the past 3 days when I abort it I get another one about 2 hours later and need to take another shot and the pain goes away. But I am PF the rest of the night and day just between 7pm -10 pm I get killed. This is my 2nd year using Imitrex nasal spray. Should I be concern? Last night I tried not to use Imitrx the first time( I took 1500 mg of motrin to take the edge off) but still felt the pain and gave up. Feeling that the pain is more intense.
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don
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #4 on: Jun 25th, 2004, 10:07am » |
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Quote:Once you taste PF, how can you possibly go through one attack withou the Trex nectar?
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LMMFAO. Well put!
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JDH
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #5 on: Jun 25th, 2004, 10:12am » |
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I knew it!
Prior to '98 I was basically going through cycles med free and they never lasted more than about 6 weeks. Then my GP prescribed the Imitrex inhalers and later the injections and instead weeks my cycles started lasting months.
I haven't had a shot of Imitrex since early '03 and with the help of o2 and the CBer's I'm hoping to keep it that way.
Jim
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thomas
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #6 on: Jun 25th, 2004, 10:44am » |
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on Jun 25th, 2004, 9:29am, ozzman wrote:
The problem is the weaning off. Once you taste PF, how can you possibly go through one attack withou the Trex nectar?
It sucks, but it is doable.
Ozzy |
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Quality of life is better with less hits and a shorter cycle, just have to "ride it out". Thanks Floridian.  Love it when I'm right. (Happens so rarely, gotta get excited)
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Samantha_Smith
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #7 on: Jun 25th, 2004, 11:29am » |
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I agree with ozzman. The pop sample seems very, very small and half the pop was episodic and half of it was chronic. Plus the study does not address how much and how often they were injecting. Were these 6 patients using Imitrex as prescribed or were they exceeding the prescribed limit? I think both of those questions need to be answered before making any definite conclusions. Maybe I shouldn't have taken those classes in statistics and methodology.
P.S. Floridian, thanks for posting all of these studies. I LOVE to read stuff like this. (No joke.) I appreciate the time you take to search for them and post them. It gives me hope to know that headaches have not been forgotten about by the scientific community.
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Flash
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #8 on: Jun 25th, 2004, 12:09pm » |
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Want the bad news?
IMHO almost anything that aborts or prevents the headaches will lengthen the cycle and ultimately result in more severe headaches. The easiest cycles I had were drug free.
It appears as though the headaches are caused by the brain chemistry drifting slowly out of whack, mainly centering on excretions from the pineal gland that are controlled by our defective hypothalamus'. One result of the headache appears to be increased excretions. The headaches seem to occur until the brain chemistry returns to normal. Likewise there seems to be a threshhold below which the headaches occur.
One you realise all this, you can figure out how it's possible to make episodes much easier and less painful by doing things to increase secretions. This can help to stave off episodes for a long time, although they DO ALWAYS come in the end. For instance: sleeping less (actually going down to 5 or 6 hours a night is a good idea), eating a small meal every 3 hours. Eating immediately prior to bed and first thing in the morning. NEVER allow yourself toget thirsty. Take exercise in the morning for 20 mins to increase metabolism for the day.
Taking these steps I have been able to minimise headaches.
There is one treatment that doesn't have this downside though: SHROOMS! These appear to fix the brain chemistry by some other means.
Flash
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JDH
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #9 on: Jun 25th, 2004, 12:13pm » |
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on Jun 25th, 2004, 11:29am, Samantha_Smith wrote:| P.S. Floridian, thanks for posting all of these studies. I LOVE to read stuff like this. (No joke.) I appreciate the time you take to search for them and post them. It gives me hope to know that headaches have not been forgotten about by the scientific community. |
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Ditto.
You bring a lot to the table Floridian...thanks!
Jim
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Flash
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #10 on: Jun 25th, 2004, 12:26pm » |
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I should mention that I only employ that regine during the times I am episodic, the rest of the time I eat and sleep normally.
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Pinkfloyd
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #11 on: Jun 25th, 2004, 1:15pm » |
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on Jun 25th, 2004, 8:44am, floridian wrote:Lots of people here have claimed that sumatriptan (imitrex) prolongs a cycle or makes headaches more frequent, in spite of the fact that it provides quick relief on a headache by headache basis. This research suggests those people are right. Maybe trex doesn't abort a headache - it just postpones it.
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Well hells bells..
I can't wait to email this info to several doctors/researchers that have been telling me for three years that there is no evidence of such a thing.
As to the small sample size, maybe the info collected in our survey will add some data for someone to build upon.
I think someone at the convention should ask the docs from NECH for a response. Should be interesting.
PF
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BobG
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #12 on: Jun 25th, 2004, 1:30pm » |
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So....
if you use Imitrex to abort you get rid of the pain of one attack but they come back sooner and for a longer cycle.
Or, you don't use Imitrex and you have to suffer through all the pain of every attack but they are fewer for a shorter length of cycle.
Damnned if you do and damnned if you don't.
What a pisser! 
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thomas
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #13 on: Jun 25th, 2004, 1:40pm » |
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on Jun 25th, 2004, 1:30pm, BobG wrote:So....
if you use Imitrex to abort you get rid of the pain of one attack but they come back sooner and for a longer cycle.
Or, you don't use Imitrex and you have to suffer through all the pain of every attack but they are fewer for a shorter length of cycle.
Damnned if you do and damnned if you don't.
What a pisser! |
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There are a myriad of choices for abortives that are not imitrex, Bob.
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BobG
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #14 on: Jun 25th, 2004, 1:51pm » |
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on Jun 25th, 2004, 1:40pm, thomas wrote:
There are a myriad of choices for abortives that are not imitrex, Bob. |
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Have to agree. And not so hard on the heart. And cheaper.
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ozzman
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #15 on: Jun 25th, 2004, 1:56pm » |
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on Jun 25th, 2004, 1:15pm, Pinkfloyd wrote:
I think someone at the convention should ask the docs from NECH for a response. Should be interesting.
PF
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Bob, will do, don't worry about it.
I used to be episodic, then I got access to prevents and lots of abortives ("good insurance company, I guess), now I'm chronic, I've been wondering ever since...
Ozzy
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #16 on: Jun 25th, 2004, 2:23pm » |
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I remain skeptical simply because I have not experienced this. I am not saying it does not happen, but I am fairly certain it will not happen to everyone. Imitrex has always been known to cause rebound HAs, but this is something entirely different. This basically says that imitrex induces attacks (triggers) as well as aborts...although the trigger time is not short. Another thing that has me curious is to why the injections do this and not the pills or the NS.
While it is true that many abortive options exist, not everyone has options. This is due in part to some meds just not being effective as well as side effects.
Until I have negative results with trex, I'm stuck (pun intended) with it. Of course, I was chronic for 10 years before even knowing what trex is.
Chris
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #17 on: Jun 25th, 2004, 2:46pm » |
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I believe .... it is a SMALL study ... but even if it was a HUGE one, the results would look the same. Imitrex may cause longer cycles / harder hits / rebounds.
BUT ... How can you 'ride it out' when it goes for years / multiple hits everyday / severe ?? That sounds suicidal to me.
Even though Imitrex may cause these longer cycles ... doesn't mean that they cause 'chronicness'. People go chronic (severely) without even using Imitrex because of other factors. (health problems, money, doctors, lack of knowledge)
Until they find a drug that can replace Imitrex injections for me ... I'll have to use it ... even if it means death. I'm doomed to use it for a long time. I use TONS of it. Just for example ... I've used 14 (4 - 5 mg) injections in the past 36 hours (approx). There's NO end in sight. I would rather stop my SEVERE HA in 10 - 20 minutes then 'ride it out' (each one) for up to 2 hours !
But .. that's just my opinion 
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pubgirl
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #18 on: Jun 25th, 2004, 4:03pm » |
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Hi Floridian
As you probably know, we've been discussing this 'over the pond' too and think this research confirms what most believed anyway. Trouble is, many think it's true of 02 as well. 
Ho hum, if I ever go chronic, God forbid, looks like a bit of mail order shopping might be happening 
Wendy
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| « Last Edit: Jun 25th, 2004, 4:28pm by pubgirl » |
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #19 on: Jun 25th, 2004, 4:24pm » |
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I just wanted to ditto the thanks to floridian for the large amout of research he does and the information he brings to the group.
You are appreciated more than we tell you, dude.
Gator
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floridian
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #20 on: Jun 25th, 2004, 4:38pm » |
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Thanks for all the compliments, now stop it before my ego swells anymore.
Quote:| Trouble is, many think it's true of 02 as well. |
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That's a scary thought. I'm hoping that isn't true.
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| « Last Edit: Jun 25th, 2004, 4:42pm by floridian » |
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Re: Fresh Research - Imitrex Increases Heada
« Reply #21 on: Jun 25th, 2004, 5:13pm » |
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on Jun 25th, 2004, 4:04pm, andy wrote:Floridian, Thanks for the info.
I have wondered about this for some time. I am episodic with cycles every few years. I am med free and have been for a long time. My cycles usually last 6-8 weeks with only 02 to abort. I have used the injections a few times, They work great but are very expensive. 02 is cheap, safe, and it works almost all the time.
i have been getting hit a few times daily for a month or so. I have not used trex this cycle. And i hope not to.
........andy
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That's a nice looking little homemade headache bong you have there... 
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pubgirl
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #22 on: Jun 25th, 2004, 6:28pm » |
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Floridian
Simplistically, what a lot of the sufferers believe is that there are x attacks there to be had, and this number is different for different people, and aborting them means only that they are postponed, not obliterated. i.e. aborting attacks with any agent prolongs the cycle and preventing the attacks works only until the preventive is stopped or the attacks break through.
The exception to this might be ONSI and shrooms/other 'mind altering drugs', but no-one knows if what is happening with these is postponement also, albeit of a longer duration? Who knows as it is all supposition really.
IF it is to do with chemical imbalances in the brain, shrooms might be the big exception, if it is physiological, maybe the right kind of surgery will be the big exception. If ONSi can be made to work more consistently and you get the stimulator for life, that could be the answer.
Just musing here really 
We need a whole generation of research, so maybe our kids will be the ones who will know.
Wendy
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| « Last Edit: Jun 25th, 2004, 6:29pm by pubgirl » |
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #23 on: Jun 25th, 2004, 6:54pm » |
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on Jun 25th, 2004, 6:28pm, pubgirl wrote: If ONSi can be made to work more consistently and you get the stimulator for life, that could be the answer.
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Wish the ONSI would've worked for me. Still never done shrooms. Maybe soon !!! (hopefully)
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Re: Fresh Research - Imitrex Increases Headaches
« Reply #24 on: Jun 25th, 2004, 7:35pm » |
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Whoa, I'm freakin out here.
Quote:Simplistically, what a lot of the sufferers believe is that there are x attacks there to be had, and this number is different for different people, and aborting them means only that they are postponed, not obliterated. i.e. aborting attacks with any agent prolongs the cycle and preventing the attacks works only until the preventive is stopped or the attacks break through.
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If true, this concept is biologically profound. I can't think of any other disorder that acts like that (it's almost like ovulation  ).
and...
Quote:| shrooms might be the big exception |
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if this is also true, then time travel using shrooms really is possible (of course, I already know that)
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