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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Maxalt-MLT 10 mg
        
(Message started by: chucknot on Mar 13^th, 2007, 11:05pm)

Title: Maxalt-MLT 10 mg
Post by chucknot on Mar 13^th, 2007, 11:05pm

Well, I am sitting here with my Maxalt samples and an unfilled perscription. My neurologist gave me a oncall basis for rapid entry to his office and if I want hospital. I have done nothing. My cynical nature and my aversion to pills has left me gradually sliding more and more into a period of CH's which, in my infinate wisdom, I continue to deny. But I am sitting here and typing:

So, what is the alleged function of this Maxalt? Can't even remember what the doctor said to do with the blinking things and I have not filled the prescription so, I have no instruction.

Any late night advice?

You know I really hate this...so many therapies, so little time to try everything and so little money.

Title: Re: Maxalt-MLT 10 mg
Post by E-Double on Mar 13^th, 2007, 11:24pm

it's a triptan.
Use it as an abotive though it may take a lot longer than some of the faster triptans such as zomig or imitrex

Title: Re: Maxalt-MLT 10 mg
Post by chucknot on Mar 13^th, 2007, 11:35pm

Abortive. Thanks. The ugly part of my slide is always that few weeks where there is enough randomness, PFD's and moderation of pain level that I have plenty of time to back track and work on my denial technique.

Title: Re: Maxalt-MLT 10 mg
Post by LeLimey on Mar 14^th, 2007, 3:40am

As E-Dub said Maxalt is a triptan, its one you let dissolve in your mouth.

I'm not sure if you know how triptans work so please forgive me if I'm selling snow to eskimo's! The info might help someone else at any rate.

Triptans are vaso-constrictors, they work for CH by constricting the blood vessels in your head. In a hit those blood vessels swell by up to 20x their normal size which is why they hurt so much. The only way to get rid of the pain is to reduce the size of those blood vessels.

Maxalt works but it takes longer to kick in than some other faster acting triptans. Ask your doctor if he has any samples of:

Zomig (Zolmitriptan) nasal sprays (they last for up to twelve hours blocking further hits) (take ten -15 minutes to kick in)

Imitrex (Sumatriptan) SUBCUTANEOUS INJECTIONS! NOT the pills as they take too long to kick in. The injections will start to work in 5-10 minutes and last for up to 2 hours so they are not effective for further hits but nothing works faster.

With ALL triptans you can only use a maximum of two in 24 hours however research in England by Professor Goadsby has stated that you CAN use three Zomig in 24 hours if necessary.

Right thats the triptan stuff done and dusted - I'm concerned about you though, you sound like you could really use someone to talk to over this. There are several options. the chat room here, http://www.clusterheadaches.com/chat/ private messages to ANY of us or, at the top of the list, the family services team at OUCH who can help you in many many ways. I can't recommend you contacting them highly enough, they are knowledgable compassionate individuals who care deeply about what sufferers and our supporters go through. Email them on familyservices@ouch-us.org

Given that you've mentioned the cost involved with CH I'm going to recommend some "home remedies alot of us have found really effective.

Strong coffee - caffeine is a vaso constrictor, if you can chug a cup or two at the first sign of pain it can abort a hit. Very effective for alot of us!

Red Bull or generic high energy equivalents - lots of caffeine so also very effective if chugged ASAP. It isn't a taste I care for, I hate it but I love the effects! These also contain Taurine which increases the effect of caffeine sort of like a turbo boost!

Both of these work best by using them as soon as possible, as with everything else for CH, the longeryou let a hit ramp up the harder it becomes to shift.

Ice/Heat. Ice packs work for me but alot of others swear by heat, its worth trying if you haven't already. I'm sure you already know if heat or cold are a trigger for you.

Have you tried any other prescription drugs or preventatives such as verapamil? Have you ever tried high flow Oxygen? (also a vaso constrictor)

Lastly, (I'll bet you're relieved!) lets talk about this denial technique of yours - oh yes, its kick up the bum time! Denial is fine for when your cycle ends and you can forget it until the next time or even better, hopefully never - however in mid cycle you are wasting your life by suffering this shit for a single minute longer than you have to. Life is too short and too precious to let this revolting condition have any of it you can claw back.

We will help you, we'll be standing here cheering when you find something that works for you I promise. You meet us halfway and we'll get through this together.

Now I'm going to be looking for your reply to this and I have a reputation here as a ROYAL bitch so don't make me angry okay?! ;)

Pain free time to you soon
Helen

Title: Re: Maxalt-MLT 10 mg
Post by chucknot on Mar 14^th, 2007, 9:14am

Thanks for this LeLimey. I did not see your post til this am and I am headed off to work. I am in US Mountain time so you are a bit ahead of me on the clock. Really to date I have had O2, Prednisone, Indocine and now Maxalt. I have read this site a good bit several years ago at my last episode. By real (noteably limited) and vicarious exsperience reading here it is really a crap shoot and hard to tell what may work. That combined with the superstition of desperation leaves me in doubt of many approaches. But, of course, in desperation who will not try most anything? Can only guess at why I went from twice a year undiagnosed to a 3 year break and then a 6 year break. I thought it might have to do with injury sustained in the interim, of my self medication theory and stratagy. Apparently, it was just random dumb luck.
I did find a constant supply of hot towels helped keep the the pain level a little managable (rocking, not groveling and thrashing about on the floor) but my wife had to keep the towel supply coming constant through the CH...not practical. Not to mention the scorched right side of the face and head.

And yes, cost is a problem in this household like many. It makes many appealing approaches unobtainable. Even imitrex is a bit out of reach in the quantities I imagine would be needed.
Cheers.

Title: Re: Maxalt-MLT 10 mg
Post by thebbz on Mar 14^th, 2007, 10:48am

Gosh Helen your good! What she said. I would only add hang tough and you may want to try 02 again, this time with a clustermasx. clustermasx.com (02 has to be administered correctly to work.) At onset immediate 100% o2, 12 to 15lpm for 20 min. works wonders. Save the triptans for the nighttime hits and use the others in the daytime.
all the best
jb

Title: Re: Maxalt-MLT 10 mg
Post by Brewcrew on Mar 14^th, 2007, 12:05pm

on 03/14/07 at 09:14:32, chucknot wrote:

That combined with the superstition of desperation leaves me in doubt of many approaches. But, of course, in desperation who will not try most anything?

Just don't let your desperation lead to half-assed attempts at anything. Give any new drug or therapy a real chance to work.

I'm convinced that if the 30% of clusterheads who report that O2 doesn't work for them really gave it a chance (and used it properly), it would drop to 10% or less just like that.

Title: Re: Maxalt-MLT 10 mg
Post by LeLimey on Mar 14^th, 2007, 2:07pm

on 03/14/07 at 09:14:32, chucknot wrote:

Hello again!
Thats for the further info, it definitely makes it easier to help you knowing what you have and haven't tried.

Pred DOES work well for CH, if it didn't I would hazard a guess you weren't at a high enough dose. A common starting point tends to be around 70-80mg a day but obviously your doctor knows you and your medical history, build etc and needs to make the final judgement. Anything less than 40mg as a starting point is not usually effective. Pred is a nasty old drug as you probably know and shouldn't be used for long periods, for CH we start with the higest dose for a week and then usually taper down by 5mg every 4-5 days. You MUST taper off it, thats imperative or your body won't react nicely!

Pred is usually started in conjunction with a preventative. These work by trying to influence your cycle rather than each individual hit. The most common one is Verapamil and although you will start lower you can taper up as far as 960mg on it. Most people find relief at around 480mg although its very personal and you'll just have to find your own level (ie the point at which the hits stop or reduce dramatically) You need to have an ECG before starting Verapamil and one at every increase (usually 4-7 days) Verap is blood pressure med hence the need for the ECG's - its precaution more than anything.

Neither of these are as expensive as triptans so will be less of a problem, they're both pretty "common" drugs.

If heat helps why not invest in one of those wheat or corn bags you can buy or make? I'll ask people who have made them to post their tips for you. You can heat those in the microwave and with the money you save on laundry detergent and drying you can buy your wife a ginormous bouquet of flowers as a thank you for putting up with you! ;;D

She is very welcome here too by the way, supporters have a hard road to walk watching us through this pain and there is endless help and support here for her too.

Definitely try the caffeine tips too - they have been worth their weight in gold to me, just remember THE golden rule, get it down your neck as fast and as early as possible! Its no time to be ladylike ;)

Lastly, definitely definitely definitely try the O2 again. I can't reiterate enough what the others have said about it working for people who never thought it would because they haven't been using it right. There is a definite knack to it and OH!! The relief! Its my wonder "drug" I can tell you!

Hope today is going better for you
Helen

PS I'm usually six hours ahead of you but for the next two weeks its only five since you changed your clocks early!

Title: Re: Maxalt-MLT 10 mg
Post by Redd on Mar 14^th, 2007, 2:29pm

Helen asked me to post about how to make bags for heat for you to save on laundry...

Here is one that can be used hot or cold.

Buy navy beans in big bags at the grocery. Buy a pair or two of heavy duty tube socks, and fill with the beans. Either sew or tie off the ends. Freeze ...or in your case, heat in the micro untill desired temp. One thing you do not want to do is use the same bag of beans for both. Beans that have been frozen can absorb enough moisture to get soft in the middle, and then if you heat them, they can explode. Maybe use one color sock for the frozen ones and another for the ones you heat. The cold ones are still good for the bumps and bruises we get while dancing around in the dark with the beast.

Title: Re: Maxalt-MLT 10 mg
Post by chucknot on Mar 14^th, 2007, 8:50pm

Thanks so much. Have seen a fair bit of advice on the site. I am pretty sure that I have missed a lot but your post is phrased in a way that sort of gives me an ABC approach to my stratagy. I have to keep working and we are shorthanded currently. my situation is ramping up more and more which is a little odd for me. I am in uncharted water here as to how my syptoms are proceeding. They are progressing differently from former years.
The O2 was likely not used properly given review of what is being said. And the prednisone may have been on the low side (60 mg tapering). Don't like pred at all...nasty bit of work. Doc say's big bang for the buck hospital entry will work but I have neither time nor money.
At any rate I will be calling the doctor to see what kind of phone meds he can arrange like Zoomig which sounds attractive. If I can get enough sleep and bring down the pain level...I will be good to go I think. I made it many years with nothing and only my last round had me sidelined for about 6 to 8 weeks...with basically ineffective or misused ineffective tools. And I no longer have the means to conceal my disfunction at work. My main focus is keeping my wife and daughter fed and to do that I must work so, I am hoping that what I have been reading on this site means that people are able to exert some real limits or control on "the beast". It sure seems so at least. There is nothing quite as humbling and fear inspiring as loosing the brut force to persist.

Title: Re: Maxalt-MLT 10 mg
Post by LeLimey on Mar 15^th, 2007, 7:37am

For CH with sleep issues many people here swear by melatonin which you can buy OTC. Usual doses are 6-9mg a night. You might like to have a look at various threads on this board (meds) for both melatonin and benadryl as that gets used too.

If ever you DO try Pred again make sure its started WITH a preventative such as verapamil, using pred without a prevent is pointless unless you have a cycle of two weeks or so.

Mind you, given that it CAN take up to six weeks for prevents to kick in dependant on how fast your doc lets you increase dosage if a cycle is less than that I wouldn't recommend them at all but would just suggest people stuck to abortives as anecdotal evidence (not official research) suggests alot of people feel preventatives have lengthened their cycles.

Good luck with talking to your doc, let us know how you get on okay?

Helen

Title: Re: Maxalt-MLT 10 mg
Post by StressFree on Mar 23^rd, 2007, 12:01pm

Hello Chucknot,

I hope you are doing well. I see your first post was over a week ago. Maxalt worked for me, though sometimes a second 10mg was required. Not to be taken multiple times daily though, and not with heart problems. Not all Maxalt is "melt under tongue" type. I usually take one with hot water at first sign of attack. Usually 15 to 20 minutes and all is well. They seem to be longer lasting than Imitrex (in my case). I had extremely bad recurring clusters with Imitrex pills. Best of luck, and ernest prayers for you. Rich
P.S. I too have had longer and longer periods of remission. I seem to get triggered with combination of mental stress (work/significant life events/etc) and extreme cold/flu/allergy physical stress around the same time.