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        New Message Board Archives >> 2004-2005 Getting to Know Ya Posts >> Hello people...
        
(Message started by: AlanM on Sep 24^th, 2004, 6:08pm)

Title: Hello people...
Post by AlanM on Sep 24^th, 2004, 6:08pm

Thought I'd register and join in and say hello.

I'm in the UK and have been plagued with CH since about 15 years old.. (Now 29). Only within the last 4 or so years that I discovered what the headaches actually were and was diagnosed by my doc.

I'm episodic and get my yearly 6-8 week bout anytime from September onwards.. (In week 2 at the moment). I also drink anything between 20 and 40 pints of alcohol per week - so the CH bout also acts as my yearly 'dry out' period!

Only started on medication for my CH about 5 years ago when I was given Pizotifen 0.5mg which did the trick for a couple of years. (Although all the years I've been taking this, there has always been a large amount of 'breakthrough' attacks). Then 0.5mg became inaffective so the doc prescribed 1.5mg instead. That too worked OK for a couple of years but this year found the 1.5mg to be pretty much useless. Been taking up to 3x1.5mg tabs per day and no joy so just been back to the doc today.

He's now given me a sumatriptan (6mg) injection pack which sits here ready and waiting. I've not yet had an attack today so I at the moment, cannot comment on what this will do for me. No doubt I will post here later with my findings! ;)

From reading the posts of others, it would seem the doc has given me something that is widely recognised as a key drug for CH sufferers but I also read with interest that some are concerned about its side effects.

It would seem quite a bizarre thing to say at the moment - as I've not yet used the drug - but I am quite eager for an attack to occur so I can see if this is going to work for me. For me, the knowledge that an attack will happen at some point soon is almost as painful as an attack itself. Living in fear of something is not good so if this works then there is light at the end of my particular tunnel.

Title: Re: Hello people...
Post by Jonny on Sep 24^th, 2004, 6:16pm

Welcome to the family, Alan,

Imitrex (sumatriptan) could very well be your life saver in this hell we call CH.

Be sure to check out this site http://www.clusterheadaches.org.uk/home/index.cfm?address=../home/txt_welcome.cfm&added=Dec2001&code=AD

......................................jonny

Title: Re: Hello people...
Post by yikes_another_one on Sep 24^th, 2004, 7:33pm

Maybe I sprayed it wrong, but Imitrex never completely took away the problem.
Zomig....cut my attack clod turkey....but Imitrex,
well, it dulled the pain from a 9 to a 5...

but the eye still drooped
and the nose was still stuffed up.

Good luck and let us know how it works for ya

Title: Re: Hello people...
Post by Jonny on Sep 24^th, 2004, 8:11pm

on 09/24/04 at 19:33:53, yikes_another_one wrote:

Maybe I sprayed it wrong, but Imitrex never completely took away the problem.

Maybe you missed where he said "Injections".......Theres no spray with injects ::)

...................................jonny

Title: Re: Hello people...
Post by AlanM on Sep 24^th, 2004, 9:22pm

Not had an attack yet (2:28 am GMT) but been doing a bit of research into this sumatriptan (branded Imigran over here).

Now I am overweight 6' 1" and 18 1/2 stone (117kg) with a BMI of 34 which dumps me in the obese category. I smoke and am generally rather unfit. All heart risks that need to be taken into consideration with this drug.

I think I should check again with the doc before injecting this. He didn't mention it when he prescribed it but then he only suggested it after referring to some quarterly issue medical/drug 'bible' he had in his drawer.

Any others using this in a similar situation?

TIA

Title: Re: Hello people...
Post by Filbert on Sep 24^th, 2004, 9:27pm

Hi Alan and welcome to the board
You're right the Imi injections work very well for most CH sufferers and for me worked in about 3-5 minutes. Like you I was many years undiagnosed and thought I was going mad. O2 is another good abortive which works well for many people.
The link Jonny posted is a good one so try and check it out!
Anyway I hope you get some extended painfree time soon!!

All the best Filbert.

Title: Re: Hello people...
Post by AlanM on Sep 24^th, 2004, 11:07pm

Update... Time now 4:05am GMT. CH attack occured roughly 10 mins ago.. Injection administered at 3:57am. In the past eight minutes the pain has just disappeared totally!!! :D

Feel a bit giddy although that may just be the fact that's it's worked like a dream. Gonna stay awake for another 30 mins or so and see if any side effects occur....

Title: Re: Hello people...
Post by AlanM on Sep 24^th, 2004, 11:37pm

Well still feelin' fine... Just been working out that this is going to cost a small fortune... I've read the 'imitrex tip' article from the main menu and may have to try that...

So 1 repeat prescription costs £6.40 and that contains 2 doses. Say that's one attack a day and they last for a further 4 weeks. That's 14 packs totalling £89.60!!

To be PF - Small price to pay in comparison thinking about it.

At least after this period is over with, I've got another 10 months or so to save up for the next one!

Title: Re: Hello people...
Post by thebbz on Sep 26^th, 2004, 7:30pm

Hello UK,
Keep up the studies on your condition. Imitrex gives me instant relief. Depending on the cycle and timing for up to 12 hours. Then its time to shooter again.
Hope your pain is gone and stay in touch. There are alot of good peoples and information here and check out the OUCH website.
BB 8)

Title: Re: Hello people...
Post by FZfan on Sep 27^th, 2004, 8:13am

AlanM,

Welcome to clusterville. Glad the injections are working for you. I would urge you to get some o2 and try it. When you get attacked at home, it is a good alternative to the injections, and then you can save the injections for when you are not at home. Cheaper, too.

Check out the oxygen info button on the menu to your left. For o2 to be effective it has to be used correctly.

Title: Re: Hello people...
Post by nani on Sep 27^th, 2004, 9:20am

Welcome Alan I,too am in the obese, smoker w/ high blood pressure category. My primary care doc suggests that I only take the Imitrex for severe HAs to lessen any possibility of heart attacks. I'm seeing a neuro in a couple of weeks and I'm going to see what other options I may have. O2 is a good abortive and Verapamil is a good preventative. It also got my BP down to a healthier level. Good luck! :)

Title: Re: Hello people...
Post by pubgirl on Sep 27^th, 2004, 6:46pm

Hello Alan

Welcome to clusterheadaches.com and hoping to welcome you to OUCH Uk at some point. :D

Better to check the 02 links on the OUCH Uk site Jonny very kindly provided the link to as they are much more relevant for the UK

Wendy

Title: Re: Hello people...
Post by floridian on Sep 28^th, 2004, 8:43am

Your right in concluding that triptans are very effective for many people with CH, and that there is some heart risk. Do more research and talk it over with your doctor. Using the least amount of imitrex that will stop the pain is a good idea (ie, the "imitrex tip" to the left).

If you have basilar migraine, don't use triptans.

Quote:

Headache. 2004 May;44 Suppl 1:S20-30.

Cardiovascular tolerability and safety of triptans: a review of clinical data.

Dodick DW, Martin VT, Smith T, Silberstein S.
Department of Neurology, Mayo Clinic Scottsdale, AZ 85359, USA.

Triptans are not widely used in clinical practice despite their well-established efficacy, endorsement by the US Headache Consortium, and the demonstrable need to employ effective intervention to reduce migraine-associated disability. Although the relatively restricted use of triptans may be attributed to several factors, research suggests that prescribers' concerns about cardiovascular safety prominently figure in limiting their use. This article reviews clinical data--including results of clinical trials, postmarketing studies and surveillance, and pharmacodynamic studies--relevant to assessing the cardiovascular safety profile of the triptans. These data demonstrate that triptans are generally well tolerated. Chest symptoms occurring during use of triptans are usually nonserious and usually not attributed to ischemia. Incidence of triptan-associated serious cardiovascular adverse events in both clinical trials and clinical practice appears to be extremely low. When they do occur, serious cardiovascular events have most often been reported in patients at significant cardiovascular risk or in those with overt cardiovascular disease. Adverse cardiovascular events also have occurred, however, in patients without evidence of cardiovascular disease. Several lines of evidence suggest that nonischemic mechanisms are responsible for sumatriptan-associated chest symptoms, although the mechanism of chest symptoms has not been determined to date. Importantly, most of the clinical trials and clinical practice data on triptans are derived from patients without known cardiovascular disease. Therefore, the conclusions of this review cannot be extended to patients with cardiovascular disease. The cardiovascular safety profile of triptans favors their use in the absence of contraindications.

Quote:

Headache. 2004 Jul-Aug;44(7):652-60.

When to stress over triptans: a Markov analysis of cardiovascular risk in migraine treatment.

Orlando LA, Matchar DB.
Duke University Medical Center, Durham VA, NC, USA.

BACKGROUND: Migraines affect 10% of the U.S. population and the episodes are frequently associated with significant disability. Triptans, 5HT1 receptor agonists, can be highly effective in treating pain and reducing disability. However, reports of cardiac events associated with triptan ingestion have led to concerns about its use in the face of possible cardiac disease. OBJECTIVE: Should a patient without known cardiovascular disease (CAD) and moderately severe to severe migraines undergo cardiovascular testing prior to the initiation of triptan therapy? DESIGN: A Markov model of migraine and cardiac disease using DATA 4.0. Three strategies were compared: (1) use triptans without further evaluation (TREAT); (2) test, then treat if negative (TEST); and (3) avoid triptans (NOTRIPTAN). Triptans were prohibited if a cardiac event occurred. DATA: Model inputs were derived from the literature and subjected to sensitivity analyses across all possible values. TIME HORIZON: Markov cycle is 1 week. OUTCOMES: The primary outcomes of interest were quality-adjusted life expectancy, in years (QALYs) and the impact of various cardiovascular risk levels on the preferred strategy. RESULTS: For the base case results were TREAT 19.4 QALYs, TEST 19.2, NOTRIPTAN 19.1. When altering CAD probability: TREAT dominated from 0 to 87%, TEST 87% to 97%, and NOTRIPTAN above 97%. Results were robust during sensitivity analyses. CONCLUSIONS: This analysis suggests that even for individuals with a relatively high risk of CAD it is not beneficial to perform cardiac testing, nor to avoid triptans. The exact level of cardiac risk at which testing should be considered is probably at or above 87%.