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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Prozac has kept me headache free for 6 years
        
(Message started by: CHISHELL on Jun 9^th, 2006, 9:43am)

Title: Prozac has kept me headache free for 6 years
Post by CHISHELL on Jun 9^th, 2006, 9:43am

Hi folks.

I am 40 years of age. I started with CH's when I was 17. I got them episodic, about every 18 months.

At first I just took pain killers and used an ice pack on my temple. Then, in 1995, I got the internet and started to research them. I learned that oxygen could help, so I tried that. It worked to an extent but did not eradicate the pain lower than 5 on the 'kip scale'.

In my 30's I tried Imigran (Imitrex in US) injections. Wow! They killed the pain almost instantly. This was a major change in my life which made "the beast" less frightening. Imigran still meant awkwardness though and although a Godsend was not the perfect solution.

From the very early days of researching my CH's I knew Seratonin was an important factor in the headache itself. I made the link with Prozac quite early. It seemed to me common sense that if Seratonin levels drop during sleep, resulting in CH, then surely giving the brain more Seratonin would help.

When my doctor prescribed Prozac (fluroxitine) for depression in 2000 I could not believe my luck. Here was my chance to test my theory without convoluted explanations to my doctor about how Prozac might work for my CH: I had the perfect excuse.

The Prozac seems to suit me. My moods are better and my depression has vanished. I don't feel like a zombie at all. Best of all though, my headaches have vanished. Since taking Prozac I have not even had a twinge!

I believe my headaches have gone because my brain now gets the seratonin it needs. The longest I had ever gone without a CH before Prozac was 18 months. Now I have not had one for 6 years. I take 1 x 20mg tablet every three days.

I know that people might be cynical and I'm not saying it would work for everyone. All I can tell you, hand on heart, is my headaches have gone.

I know the pain of CH. It's unbelievable. I never gave up trying to find a solution and now I think I've found mine. Of course, only time will tell but I'm pretty confident Prozac is my miracle worker. :)

Simon. UK

Title: Re: Prozac has kept me headache free for 6 years
Post by floridian on Jun 9^th, 2006, 1:11pm

Glad it works for you, I have heard a few others say the same, although, for most, it doesnt help. Controlled trials using SSRIs like prozac for migraine also found little or no effect. The older tricyclics seem to help a higher percent of people with neurovascular headache.

Title: Re: Prozac has kept me headache free for 6 years
Post by vig on Jun 9^th, 2006, 1:49pm

There was no question that Amitryptaline worked for CH for me.

The issue was the side effects and they can be pretty harsh.

What are the side effects of Prozac?

Title: Re: Prozac has kept me headache free for 6 years
Post by BikerBob on Jun 9^th, 2006, 6:15pm

on 06/09/06 at 13:49:00, vig wrote:

What are the side effects of Prozac?

One of the side effects of Prozac is that it blocks the therapeutic effects of LSD and LSA, and to some extent psilocybin.

I think the other side effects are rather insignificant. Here are the others:

http://www.rxlist.com/cgi/generic/fluoxetine_ad.htm

BB

Title: Re: Prozac has kept me headache free for 6 years
Post by floridian on Jun 9^th, 2006, 7:56pm

on 06/09/06 at 18:15:41, BikerBob wrote:

Hmmm ... I know a few people on this board that reported that prozac caused electric 'zaps,' disturbed sleep, loss of libido, dependency and a hellish withdraw when they stopped ... doesn't sound too minor to me.

Title: Re: Prozac has kept me headache free for 6 years
Post by Jonny on Jun 9^th, 2006, 8:03pm

on 06/09/06 at 19:56:29, floridian wrote:

doesn't sound too minor to me.

Thats because your not on LSD, Flo.....LMAO ;;D

Title: Re: Prozac has kept me headache free for 6 years
Post by BikerBob on Jun 9^th, 2006, 8:08pm

on 06/09/06 at 19:56:29, floridian wrote:

Did you see the percentages in the charts in the link I posted about adverse effects from Prozac vs. placebo?

BB

Title: Re: Prozac has kept me headache free for 6 years
Post by Jonny on Jun 9^th, 2006, 8:35pm

Mom, get the popcorn! ;;D

Title: Re: Prozac has kept me headache free for 6 years
Post by floridian on Jun 10^th, 2006, 8:49am

on 06/09/06 at 20:08:08, BikerBob wrote:

Did you see the percentages in the charts in the link I posted about adverse effects from Prozac vs. placebo?

BB

Yes, I took some time to read the whole thing. Although the top had tables of raw numbers that were apples and oranges, the bottom had the conclusions:

Quote:

Events are classified within body system categories using the following definitions: frequent adverse events are defined as those occurring on one or more occasions in at least 1/100 patients; infrequent adverse events are those occurring in 1/100 to 1/1000 patients; rare events are those occurring in less than 1/1000 patients.

Body as a Whole ¾ Frequent: chest pain, chills; Infrequent: chills and fever, face edema, intentional overdose, malaise, pelvic pain, suicide attempt; Rare: acute abdominal syndrome, hypothermia, intentional injury, neuroleptic malignant syndrome1, photosensitivity reaction.

Cardiovascular System ¾ Frequent: hemorrhage, hypertension, palpitation; Infrequent: angina pectoris, arrhythmia, congestive heart failure, hypotension, migraine, myocardial infarct, postural hypotension, syncope, tachycardia, vascular headache; Rare: atrial fibrillation, bradycardia, cerebral embolism, cerebral ischemia, cerebrovascular accident, extrasystoles, heart arrest, heart block, pallor, peripheral vascular disorder, phlebitis, shock, thrombophlebitis, thrombosis, vasospasm, ventricular arrhythmia, ventricular extrasystoles, ventricular fibrillation.

Digestive System ¾ Frequent: increased appetite, nausea and vomiting; Infrequent: aphthous stomatitis, cholelithiasis, colitis, dysphagia, eructation, esophagitis, gastritis, gastroenteritis, glossitis, gum hemorrhage, hyperchlorhydria, increased salivation, liver function tests abnormal, melena, mouth ulceration, nausea/vomiting/diarrhea, stomach ulcer, stomatitis, thirst; Rare: biliary pain, bloody diarrhea, cholecystitis, duodenal ulcer, enteritis, esophageal ulcer, fecal incontinence, gastrointestinal hemorrhage, hematemesis, hemorrhage of colon, hepatitis, intestinal obstruction, liver fatty deposit, pancreatitis, peptic ulcer, rectal hemorrhage, salivary gland enlargement, stomach ulcer hemorrhage, tongue edema.

--continued --

Title: Re: Prozac has kept me headache free for 6 years
Post by floridian on Jun 10^th, 2006, 8:50am

Quote:

Endocrine System ¾ Infrequent: hypothyroidism; Rare: diabetic acidosis, diabetes mellitus.

Hemic and Lymphatic System ¾ Infrequent: anemia, ecchymosis; Rare: blood dyscrasia, hypochromic anemia, leukopenia, lymphedema, lymphocytosis, petechia, purpura, thrombocythemia, thrombocytopenia.

Metabolic and Nutritional ¾ Frequent: weight gain; Infrequent: dehydration, generalized edema, gout, hypercholesteremia, hyperlipemia, hypokalemia, peripheral edema; Rare: alcohol intolerance, alkaline phosphatase increased, BUN increased, creatine phosphokinase increased, hyperkalemia, hyperuricemia, hypocalcemia, iron deficiency anemia, SGPT increased.

Musculoskeletal System ¾ Infrequent: arthritis, bone pain, bursitis, leg cramps, tenosynovitis; Rare: arthrosis, chondrodystrophy, myasthenia, myopathy, myositis, osteomyelitis, osteoporosis, rheumatoid arthritis.

Nervous System ¾ Frequent: agitation, amnesia, confusion, emotional lability, sleep disorder; Infrequent: abnormal gait, acute brain syndrome, akathisia, apathy, ataxia, buccoglossal syndrome, CNS depression, CNS stimulation, depersonalization, euphoria, hallucinations, hostility, hyperkinesia, hypertonia, hypesthesia, incoordination, libido increased, myoclonus, neuralgia, neuropathy, neurosis, paranoid reaction, personality disorder2 , psychosis, vertigo; Rare: abnormal electroencephalogram, antisocial reaction, circumoral paresthesia, coma, delusions, dysarthria, dystonia, extrapyramidal syndrome, foot drop, hyperesthesia, neuritis, paralysis, reflexes decreased, reflexes increased, stupor.

Respiratory System ¾ Infrequent: asthma, epistaxis, hiccup, hyperventilation; Rare: apnea, atelectasis, cough decreased, emphysema, hemoptysis, hypoventilation, hypoxia, larynx edema, lung edema, pneumothorax, stridor.

Skin and Appendages ¾ Infrequent: acne, alopecia, contact dermatitis, eczema, maculopapular rash, skin discoloration, skin ulcer, vesiculobullous rash; Rare: furunculosis, herpes zoster, hirsutism, petechial rash, psoriasis, purpuric rash, pustular rash, seborrhea.

Special Senses ¾ Frequent: ear pain, taste perversion, tinnitus; Infrequent: conjunctivitis, dry eyes, mydriasis, photophobia; Rare: blepharitis, deafness, diplopia, exophthalmos, eye hemorrhage, glaucoma, hyperacusis, iritis, parosmia, scleritis, strabismus, taste loss, visual field defect.

Urogenital System ¾ Frequent: urinary frequency; Infrequent: abortion 3 , albuminuria, amenorrhea 3 , anorgasmia, breast enlargement, breast pain, cystitis, dysuria, female lactation 3 , fibrocystic breast 3 , hematuria, leukorrhea 3 , menorrhagia 3 , metrorrhagia 3 , nocturia, polyuria, urinary incontinence, urinary retention, urinary urgency, vaginal hemorrhage 3 ; Rare: breast engorgement, glycosuria, hypomenorrhea 3 , kidney pain, oliguria, priapism 3 , uterine hemorrhage 3 , uterine fibroids enlarged 3 .

Prozac has helped people with a variety of problems. And the side effcts of prozac are probably much milder than that of Paxil and other SSRI drugs. I'm not arguing that it be banned, or that no one take it.. But there are significant side effects, and FOR CLUSTERS and other neurovascular headaches, it is not very effective compared to other drugs. If someone takes it for another condition and it helps them with the clusters, great. But I don't think there is evidence that cluster heads should seek prozac or other SSRIs for headaches, as the benefits are low, and the risks are there - not high, but significant.

Title: Re: Prozac has kept me headache free for 6 years
Post by Kevin_M on Jun 10^th, 2006, 9:57am

Well worded Jon.

Title: Re: Prozac has kept me headache free for 6 years
Post by seasonalboomer on Jun 12^th, 2006, 9:21am

on 06/10/06 at 09:57:28, Kevin_M wrote:

Well worded Jon.

as always.... thanks Jonathan.

Title: Re: Prozac has kept me headache free for 6 years
Post by CHISHELL on Jun 13^th, 2006, 5:39am

Which studies have shown that Prozac has had little or no effect; do you have a link ?

As for side effects...

All drugs have potential side effects. I have had none with Fluroxitine.

Maybe I am one of the lucky ones. However, it does seem to me a rather large coincidence that I thought fluroxitine may help because of the seratonin increase and it did.

Whatever the supposed risks of Fluroxitine, the benefits far outweigh them (for myself at least). As we all know, the trauma of CH is in some cases so bad that suicide can result. Now that is one hell of a side effect!

I only take 1 x 20mg every three days. That is a very small dose.

I think CH sufferes could look at trying fluroxitine. It takes two weeks for the build up of seratonin to kick in. If it doesn't work then you havn't really lost that much or put yourself at that great a risk. Of course, this is a very subjective and personal opinion based on my own experience.

Maybe the beast will wake me in the future and have me rubbing my temple like frenzied madman. However, he hasn't paid me a visit for 6 years now. While he stays away I'll keep taking the medication

;)

Title: Re: Prozac has kept me headache free for 6 years
Post by chewy on Jun 13^th, 2006, 7:02am

I highly doubt that using an antidepressant alone would keep me CH free. Or anyone for that matter. It may help but completely prevent? I doubt it.

CH is to unpredictable.

My guess would be you are simply in remission. I am in a 4th year remission and using no meds.
Stating Prozac has kept you pain free has as much foundation as me stating that taking no meds has kept me painfree for 4 years.

Title: Re: Prozac has kept me headache free for 6 years
Post by floridian on Jun 13^th, 2006, 12:50pm

No studies have been done on SSRIs and cluster headache - one of the problems of a 'rare' disease.

The Cochrane Database Systemic Reviews are attempts to pull together the various studies and integrate them into one answer. For migraine, the type of headache most closely related, tricyclics are effective in preventing and SSRIs are not. The Cochrane studies are not perfect - there could be a small percent of people who definitely respond to SSRIs but they get lost in the statistical noise. In theory, there could be enough of a difference between migraine and cluster so that even though SSRIs don't work for migraine, they do for cluster.

Quote:

Cochrane Database Syst Rev. 2005 Jul 20;(3):CD002919.

Selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headaches.

Moja PL, Cusi C, Sterzi RR, Canepari C.

Centro Cochrane Italiano, Istituto Mario Negri, Via Eritrea, 62, Milano, Italy, 20157. moja@marionegri.it

BACKGROUND: Headache is a common medical problem. In view of recent discoveries about the role of serotonin in pain mechanisms, selective serotonin re-uptake inhibitors (SSRIs) have been evaluated for the prevention of migraine and tension-type headaches (TTH). OBJECTIVES: To evaluate the efficacy and tolerability of SSRIs for preventing migraine and TTH. SEARCH STRATEGY: We searched MEDLINE (1966-2004), EMBASE (1994-2003), the Cochrane Central Register of Controlled Trials (Issue 4, 2003), and reference lists of retrieved articles. Headache Quarterly was hand searched from 1990 to 2003. SELECTION CRITERIA: We included randomised controlled trials comparing SSRIs with any type of control intervention in patients of either sex, over 18 years of age, with migraine or TTH. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data (headache frequency, index, severity, and duration; use of symptomatic/analgesic medication; days off work; quality of life; mood improvement; cost-effectiveness; and adverse events) and assessed the methodological quality of trials. MAIN RESULTS: Thirteen studies utilizing five SSRIs met the inclusion criteria (636 participants). Most of the included studies had methodological and/or reporting shortcomings; follow up rarely extended beyond 3 months.After 2 months SSRIs did not significantly lower headache index scores in patients with migraine when compared to placebo (SMD -0.14; 95% CI -0.57 to 0.30). Patients with chronic TTH treated with an SSRI had a significantly higher analgesic intake of 5 more doses per month when compared to patients treated with a tricyclic antidepressant (WMD 4.98; 95% CI 1.12 to 8.84). Tricyclics also significantly reduced headache duration by 1.26 hours per day (WMD 1.26; 95% CI 0.06 to 2.45) and marginally reduced headache indexes (SMD 0.42; 95% CI 0.00 to 0.85) when compared to SSRIs in patients with chronic TTH. When the data on adverse events were considered without regard to headache diagnostic subgroups, there were no significant differences between SSRIs and placebo for withdrawals due to adverse events (Peto OR 1.02; 95% CI 0.31 to 3.34). For minor adverse events, SSRIs were generally more tolerable than tricyclics (OR 0.34; 95% CI 0.13 to 0.92). However, there were no differences in the number of patients withdrawing due to any reason in the SSRI and tricyclic groups (OR 1.01; 95% CI 0.56 to 1.80). AUTHORS' CONCLUSIONS: Over 2 months of treatment, SSRIs are no more efficacious than placebo in patients with migraine. In patients with chronic TTH, SSRIs are less efficacious than tricyclic antidepressants. In comparison with SSRIs, the burden of adverse events in patients receiving tricyclics was greater. These results are based on short-term trials and may not generalise to longer-term treatment.

Title: Re: Prozac has kept me headache free for 6 years
Post by Tom K on Jun 13^th, 2006, 3:08pm

on 06/13/06 at 12:50:42, floridian wrote:

No studies have been done on SSRIs and cluster headache...

Quote:

Miscellaneous therapies that are occasionally helpful for episodic clusters include: phenelzine (Nardil), cyproheptadine (Periactin), nifedipine (Procardia), beta blockers such as propranolol (Inderal), SSRI's (Prozac, Zoloft, Paxil), or methylphenidate (Ritalin).

http://www.headachedrugs.com/archives/preventivemeds.html

But I guess his research doesn't count. Even though he is one of the OUCH recommedned doctors...
http://www.ouch-us.org/chgeneral/doctors.htm

Title: Re: Prozac has kept me headache free for 6 years
Post by floridian on Jun 13^th, 2006, 5:42pm

on 06/13/06 at 15:08:20, Tom K wrote:

His article is based on his experiences as far as I can tell, not on a controlled trial. But I agree somewhat, I said "there could be a small percent of people who definitely respond to SSRIs but they get lost in the statistical noise." He said occasionally people may respond to SSRIs. There is no evidence of a clear cut, consistent response to SSRIs for neurovascular headache.

Title: Re: Prozac has kept me headache free for 6 years
Post by Tom K on Jun 13^th, 2006, 5:56pm

on 06/13/06 at 17:42:23, floridian wrote:

His article is based on his experiences as far as I can tell, not on a controlled trial. But I agree somewhat, I said "there could be a small percent of people who definitely respond to SSRIs but they get lost in the statistical noise." He said occasionally people may respond to SSRIs. There is no evidence of a clear cut, consistent response to SSRIs for neurovascular headache.

Missed that part in your initial post. My mistake, I appologize [smiley=bag.gif]