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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Which meds should I ask for?
        
(Message started by: AfraidOfTheDark on Apr 17^th, 2006, 2:48pm)

Title: Which meds should I ask for?
Post by AfraidOfTheDark on Apr 17^th, 2006, 2:48pm

I have an appointment tomorrow morning. All I have ever taken is Prednisone, the past month I took two packs of Prednisone, but for some reason it didn't abort the cycle as it normally does.

There are so many drugs mentioned and I'm a bit confused as to what I should try. O2 is probably not a possibility. For one thing, I have no insurance and cannot pay too much $. For another, I just don't know if I'd feel safe using O2. We heat the house with propane, open flame. My husband works with propane, is that a threat?

Should I ask for Verapamil? What about Imitrex or Melatonin? Do I need both a preventive and an abortive? I printed off the "Update on therapies for CH" link someone provided so I could show the doctor.

Also, for any drug therapies recommended, does anyone have an idea of the out of pocket expenses I can expect? (no insurance) TIA

Title: Re: Which meds should I ask for?
Post by Bob_Johnson on Apr 17^th, 2006, 3:40pm

Here is a link to read and print and take to your doctor. It describes preventive, transitional, abortive and surgical treatments for CH. (2002)

http://www.brightok.net/~mnjday/chtherapy.pdf

Print out for both you and the doc.

On a cost/effectiveness basis, Verap is effective for a good % of people. To abort attacks, Imitrex is fast but expensive. You might discuss using Zyprexa with the doc. On a dose/cost basis it's not expensive and is effective for many.

Also consider buying:
MANAGEMENT OF HEADACHE AND HEADACHE MEDICATIONS, 2nd ed. Lawrence D. Robbins, M.D.; pub. by Springer. $59 at Amazon.Com. It covers all types of headache and is primarily focused on medications. While the two chapters on CH total 42-pages, the actual relevant material is longer because of multiple references to material in chapters on migraine, reflecting the overlap in drugs used to treat. I'd suggest reading the chapters on migraine for three reasons: he makes references to CH & medications which are not in the index; there are "clinical pearls" about how to approach the treatment of headache; and, you gain better perspective on the nature of headache, in general, and the complexities of treatment (which need to be considered when we create expectations about what is possible). Finally, women will appreciate & benefit from his running information on hormones/menstrual cycles as they affect headache. Chapter on headache following head trauma, also. Obviously, I'm impressed with Robbins' work (even if the book needs the touch of a good editor!) (Somewhat longer review/content statement at 3/22/00, "Good book....")

HEADACHE HELP, Revised edition, 2000; Lawrence Robbins, M.D., Houghton Mifflin, $15. Written for a nonprofessional audience, it contains almost all the material in the preceding volume but it's much easier reading. Highly recommended.

Title: Re: Which meds should I ask for?
Post by AfraidOfTheDark on Apr 17^th, 2006, 3:53pm

The link you provided is the one I printed off for the doctor, thank you. The Zyprexa you mentioned, is that a preventive? Is it an oral or injection? All these different drugs can be confusing! [smiley=huh.gif] ;) I'm learning as I go though. But dammit, I was content to just stop by this site long enough to add to the guestbook once a year. I didn't wanna have to hang around longer! ;;D

Title: Re: Which meds should I ask for?
Post by TxBasslady on Apr 17^th, 2006, 5:23pm

I'm not a doctor.....but it's possible that the 02 is cheaper than the Triptans.

The triptan I took cost $192.00....for 9 pills. I had more than 9 headaches a month....insurance paid for 1st Rx....then I had to pay full price.

I take nothing now for my CH but 02. It's a great treatment.

Jean

Title: Re: Which meds should I ask for?
Post by brewcrew on Apr 17^th, 2006, 5:27pm

Ask for an O2 Rx and get thee to a durable medical equipment supplier.

Title: Re: Which meds should I ask for?
Post by E-Double on Apr 17^th, 2006, 5:59pm

on 04/17/06 at 15:53:03, AfraidOfTheDark wrote:

Zyprexa is used as an abortive.
I have found it to work as quickly as any triptan that I have tried and no ickyness after as well as much cheaper.
In addition you can take it with all of the other meds talked about without any risk. It is not a triptan

Great info provided!!!!
Good luck,

Eric

Title: Re: Which meds should I ask for?
Post by Richr8 on Apr 17^th, 2006, 6:35pm

on 04/17/06 at 14:48:43, AfraidOfTheDark wrote:

I took two packs of Prednisone, but for some reason it didn't abort the cycle as it normally does.

AfraidOfTheDark-Yeah, me too. However, finding this place has been a great help. I am glad you were able to find it as well.

I've had varying degrees of success with Prednisone. I guess the most important thing to remember is, not to expect it to work like it did the last time. Varying doses and durations have ended my cycle for the last three years. My most recent cycle responded to 60 mg of pred held for 7 days, then tapered off over 4 weeks. Personally, I am going to seek out an alternative approach for my next cycle. There are too many nasty side effects associated with the prednisone for my taste. Just FYI, I use O2 as a primary abortive and Verapamil at 240 mg as a prevent. Nothing has stopped my cycle, but with these meds I can get my life back under control in about 4 to 6 weeks. Of course this does not include the recovery period to get bacl a prior state fo physical condition. That's another two to three months and gets longer and more difficult each year.

Title: Re: Which meds should I ask for?
Post by Kris_in_SJ on Apr 17^th, 2006, 8:03pm

Having no insurance truly sucks, big time.

Verapamil is very affordable as a preventative, as mentioned above, though it does take a week to 10 days to kick in. I'd be tempted to try Eric's suggestion regarding Zyprexa as an abortive since just about anything in the world is cheaper that Imitrex! Just about 6 autoinjections of Trex will set you back by $400.

Good Luck!

Kris

Title: Re: Which meds should I ask for?
Post by chewy on Apr 17^th, 2006, 9:14pm

Quote:

Do I need both a preventive and an abortive?

YES!

My preventative of choice is verapamil at 480 mg per day.

My abortive is imitrex injections. Oxygen doesn't work well for me.

I use over the counter melatonin as a sleep aid. 6-9 mg.

Title: Re: Which meds should I ask for?
Post by Richr8 on Apr 17^th, 2006, 9:20pm

on 04/17/06 at 21:14:19, chewy wrote:

YES!

My preventative of choice is verapamil at 480 mg per day.

My abortive is imitrex injections. Oxygen doesn't work well for me.

I use over the counter melatonin as a sleep aid. 6-9 mg.

Ditto on the above, less Imitrex add O2. It works great for me.

Title: Re: Which meds should I ask for?
Post by unsolved1 on Apr 17^th, 2006, 10:14pm

Verapamil is one of the most common drugs used to fight CH. Lithium is another and may be used together.

Abortives include O2 (cheaper) and Imitrex or another Triptan ($$) among others.

Most of us try many things before we find something that helps, so hang in there. :)

Goodluck

UNsolved

Title: Re: Which meds should I ask for?
Post by marlinsfan on Apr 18^th, 2006, 8:38am

I've been here almost one year now, and after PLENTY of reading, I'm starting to believe, and it's just me, that some of the people who take preventatives like Verapamil will have less attacks each day, but their cycles are extended, some have even gone chronic.

I abort with caffeine, oxygen or imitrex, in that order. Last cycle, after I discovered Oxygen, I only used imitrex about 3 times. I also took prednisone last cycle. It did not cut the cycle short, and as far as I remember, my last cycle was the longest one I've had in a very long time.

I use Melatonin as a preventative of nighttime hits.

Discuss all options with your doc. Don't go in asking for a specific med.

Title: Re: Which meds should I ask for?
Post by Dragnlance on Apr 18^th, 2006, 9:10am

marlinsfan wrote

Quote:

Don't go in asking for a specific med

Do that and the doc will toss you out as a drug seeker. Any more, the doc will question you to see if you are infact a drug seeker, as there are tons of people out there that do just that

Title: Re: Which meds should I ask for?
Post by Bob_Johnson on Apr 18^th, 2006, 9:53am

Print out for your doc:

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: Which meds should I ask for?
Post by vietvet2tours on Apr 18^th, 2006, 9:58am

on 04/17/06 at 17:23:39, TxBasslady wrote:

Yep like wayyyyyyyyyy cheap.