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        New Message Board Archives >> 2005 Cluster Headache Specific Posts >> need advice - stuck in sri lanka
        
(Message started by: zebb37 on May 10^th, 2005, 11:06pm)

Title: need advice - stuck in sri lanka
Post by zebb37 on May 10^th, 2005, 11:06pm

i'm stuck in sri lanka and after a preety bad series of clusters i am almost out of my zomig. the only trhing i can find here is Pizotifen - can i use this at the same time?

am beginning to feel pretty desperate now

Title: Re: need advice - stuck in sri lanka
Post by Pinkfloyd on May 11^th, 2005, 12:37am

on 05/10/05 at 23:06:14, zebb37 wrote:

Not unless you have an emergency room REAL close. You really don't want to be stuck (6 feet under) in Sri Lanka. Not to sound too dramatic but you really don't want to take a chance on mixing these.

Pizotifen is used more as a preventive and is a 5HT receptor antagonist. Just as Zomig. You could finish the zomig and then 24 hours later, begin using the pizotifen as a preventive. Hopefully it'll work well for you.

I wouldn't even suggest having them both in your possession at the same time. Most doctors won't prescribe one without knowing the other script has been used up. They know how desperate we clusterers get.

good luck
Bobw

Title: Re: need advice - stuck in sri lanka
Post by BikerBob on May 11^th, 2005, 3:51am

Can you find O2 tanks and a 15 lpm regulator there ?

Title: Re: need advice - stuck in sri lanka
Post by sandie99 on May 11^th, 2005, 5:18am

[smiley=hug.gif]

Title: Re: need advice - stuck in sri lanka
Post by Bob_Johnson on May 11^th, 2005, 8:35am

1: Headache 2001 Sep;41(8):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.

--------------------------------------------------------------------------------

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.

Title: Re: need advice - stuck in sri lanka
Post by LeLimey on May 11^th, 2005, 9:31am

on 05/11/05 at 00:37:43, Pinkfloyd wrote:

Pizotifen is used more as a preventive and is a 5HT receptor antagonist. Just as Zomig. ....I wouldn't even suggest having them both in your possession at the same time. Most doctors won't prescribe one without knowing the other script has been used up. They know how desperate we clusterers get.

Sorry to hijack this Bob but would that be the same for someone taking imitrex and pizotifen? I know someone here in the UK who has been prescribed both by a doctor and now I'm concerned for them

Title: Re: need advice - stuck in sri lanka
Post by E-Double on May 11^th, 2005, 11:08am

http://www.drugs.com/xq/cfm/pageid_0/usr_USR27266.htm/type_USR/bn_Sandomigran%20/qx/index.htm

Title: Re: need advice - stuck in sri lanka
Post by Bob_Johnson on May 11^th, 2005, 2:14pm

LeLimey, should have made it clear that I'd suggest Zyprexa as an alternative med to abort an attack--not to be used in conjunction with other abortives.

I don't have knowledge to make judgments about interactions of the meds you mention.

Title: Re: need advice - stuck in sri lanka
Post by Pinkfloyd on May 11^th, 2005, 4:35pm

on 05/11/05 at 09:31:27, LeLimey wrote:

Sorry to hijack this Bob but would that be the same for someone taking imitrex and pizotifen? I know someone here in the UK who has been prescribed both by a doctor and now I'm concerned for them

It's not a hijack LeLimey (is that Fren-glish? ;-), when the topic stays on course...which it is IMHO.
At least your friend is doing so under a doctors care. I had/have the feeling Zebb is looking for help without being under a doctor's supervision since he's/she's out of the country.

a few thoughts..and my usual ramble disorder.....

I would suggest your friend discuss this with their doctor. I wouldn't suggest mixing 5HT antagonists like this, which would include Imitrex. It could be though that the prescribed dosages are safe in her/his case and again, under a doctor's care.
I've just read and heard of too many problems. Serotonin Syndrome is a scary possibility.

Pizotifen is an anti-histamine but is also a 5HT antagonist so it operates on a couple different levels. Just more things to have to look out for on side effects.

I'd agree with Bob J that Zyprexa might be a better choice if it could be prescribed, in this case. Although, again, we have no medical history to even base this on.

There are so many new drugs, new generics, name changes from country to country, and then add in all the different OTC's and herbs, it's getting more dangerous and more difficult to mix anything these days. Example...Feverfew, also a migraine prevent, OTC (herb) is also a 5HT antagonist.

The more options, the more careful everyone must be and the more research everyone needs to do. I don't think it's enough to rely upon your doctor and/or pharmacist to catch everything. It's your life in their hands. One mistake and they may be the only one still around to learn from it.

Over the years, I've read plenty of times where people have said their doctors weren't aware that methysergide was actually an ergot and shouldn't be prescribed along with triptans. Just as many haven't known anything about the testing required when put onto Depakote etc, etc, etc.

Bobw

Title: Re: need advice - stuck in sri lanka
Post by LeLimey on May 11^th, 2005, 5:16pm

Thanks for that Bob!

Title: Re: need advice - stuck in sri lanka
Post by Tom on May 11^th, 2005, 6:13pm

Apparently you get sumatriptan (=Imitrex®) in Sri Lanka, I found a respective hint under:

http://www.news.lk/Newsdecember_2002_232.html

Thomas

Title: Re: need advice - stuck in sri lanka
Post by zebb37 on May 12^th, 2005, 2:53pm

Pinkfloyd was absolutely correct in that i couldn't find a doctor who'd even heard of cluster headaches - I have arrived back in the uk now - abut 4hrs ago -and have my trusty meds.

Tried numerous places in sri lanka and sumatriptan appeared to definately not be available.

Ironically though- on the plane home I met an astra zeneca rep who had been setting up a zomig or as blurb said - a zimig trial within a colombo hospital.

Happily for me my clusters pettered out before I flew and I didn't need to use my last med until about 2hrs before I landed.

God I hate this time of year.

BUT a big thanks for your support there guys :)

Title: Re: need advice - stuck in sri lanka
Post by pubgirl on May 12^th, 2005, 5:25pm

thanks Pink and E-Double for the education! As you probably know I have to advise Ch sufferers on their use of drugs, many of whom are prescribed Pizotifen in the Uk by migraine educated/obsessed GPs. In my own tiny mind I have previously written off Pizotifen as an anti-histamine prescribed for migraine sufferers based on the (maybe antiquated??) thinking that there is a histamine reaction involved in TACS. I had never heard of it being any use for CH, nor that it was anything other than a harmless but useless drug for CH.

I am grateful for the education from this thread

Wendy