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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Imitrex and rebounds
        
(Message started by: Trooper on Apr 17^th, 2007, 10:06pm)

Title: Imitrex and rebounds
Post by Trooper on Apr 17^th, 2007, 10:06pm

Does anyone out there think their CH cycles have become longer since being on Imitrex? I have been on Imitrex for 4yrs and my cycles have become much more consistent in their timing and they are lasting much longer than my pre-Imitrex days. I have suffered with CH since I was 17 and I am now 34. Seems like the cycles have steadily become worse since 29 or 30. Could this be age or medicine?

Title: Re: Imitrex and rebounds
Post by UN solved on Apr 17^th, 2007, 10:59pm

The $ 64,000 question ... does it extend cycles or make them worse ? The thing is ... we really don't know for sure.

It does seem to me .... the more that I use, the more I'll need to use.

Goodluck & don't overdo it !

UNsolved

Title: Re: Imitrex and rebounds
Post by Samiam on Apr 18^th, 2007, 9:37am

I have used Imitrex since it has come out. I use it as my preventive because we can't find one that works for me. My cycle is 6 weeks and has remain 6 weeks with periods of long remission between cycles since 90. Before that I would get them every year up to 4 months out of the year. I first got clusters @ 17 and I'm now 44.

I went into cycle on Feb 24th used imitrex for 5 weeks everyday sometimes 2 x's a day and my cycle ended April 7th right on schedule. It didn't extend my hits nor did I get many more hits. So for me I would say no.

Like many said. For each it's different what works for some will not work for others.

Sami

Title: Re: Imitrex and rebounds
Post by inyoureye on Apr 19^th, 2007, 5:37pm

Not so much affected as far as cycle duration here but back to the title,....when I used the 6mg, i would have a normal headache for a few hrs after, like a tension headache and then I switched to the 4mg and its a perfect fit, no more rebound HA

Just my observations, good luck.

Title: Re: Imitrex and rebounds
Post by Chillrmn1 on Apr 19^th, 2007, 5:57pm

As for me, yes I believe Imitrex causes an increase in the frequency of attacks. I noticed this as I detoxed while in cycle to try an alternative treatment.

While using Imitrex SQ I was averaging 8 - 10 attacks daily. After detoxing for 5 days the daily attacks were down to about 4 on average. I don't believe the drop in frequency was a coincidence.

And yes the detoxing and not reaching for the injector was rough, but O2 saved me.

Edit to add: After re-reading your post it seems you were asking if anyone felt Imitrex caused extended cycles. I have not felt Imitrex caused longer cycles for me, just increased attack frequency or recurrent attacks.

Title: Re: Imitrex and rebounds
Post by Bob_Johnson on Apr 20^th, 2007, 1:01pm

: Headache. 2004 Jul;44(7):713-8. Related Articles, Links

Subcutaneous sumatriptan induces changes in frequency pattern in cluster headache patients.

Rossi P, Lorenzo GD, Formisano R, Buzzi MG.

Objectives.-To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature. Background.-Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial. Methods.-Six CH sum-naive patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described. Results.-All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. In all patients, the CH returned to its usual frequency within a few days after SQ sum was withdrawn or replaced with other drugs. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache. Conclusions.-Physicians should recognize the possibility that treatment of CH with SQ sum may be associated with an increased frequency of headache attacks.

PMID: 15209695 [PubMed - in process]

Title: Re: Imitrex and rebounds
Post by testy01 on Apr 21^st, 2007, 10:22am

Another vote against Immigran. We don't have Immitrex in Saudi, or at least I can't find it. I have used Immigran and Relpax tablets. Relpax is just a different trade name.
In any event, I can abort a Kip 7 with Immigran but in one or two hours it's back and I can guarantee it'll be an 8 or 9 this time. If I keep trying to abort the HAs with tryptans, I work myself into a really horrible position. The only abortant I've found that works for me is cafergot.

Regards

Jack

Title: Re: Imitrex and rebounds
Post by clavers on Apr 21^st, 2007, 11:18am

my neurologist took me off imitrex about four years ago on the grounds that they cause rebound CH. He put me on 1 mg injections of DHE. This seems to work better. the DHE does not abort an attack without O2 to back it up, but once it is used I can count on about 24 hours free of headache. I am chronic. DHE is cheaper than imitrex and you get more of it in a script.

Title: Re: Imitrex and rebounds
Post by Trooper on Apr 21^st, 2007, 4:06pm

Ok, so I went to the doc. on Monday to re-up my scripts and try a new approach. My cycle started 6 or 7 weeks ago and up untill Monday night I had not had a full nights sleep in over 25 days. The doc. mentioned trying a different abortive (relpax). He said that some people have more rebounds with Imitrex and relpax may be a good alternative. Funny how the minute I go to the doc. the damn beast goes off to re-group and hide for a while. I did not have another hit till Thursday night and it was only a Kip-7 that lasted about 25 minutes so did not try the relpax. Last night the beast attacked with a vengance though. It was the full blown eyeball bulging out of my head, hair ripping, head rocking, half unconsious kip 9! I ended up pukeing all over my clothes and hair on the side of the road. I swear if a cop would have saw this I would have had a hard time convincing him I was not drunk! I took the relpax at the first twinge and it did seem to work a little faster than the Imitrex pills and it does not make me feel nearly as crapy as the Imitrex pills do, however, exactly 12hrs later I woke up with another hit. So at this point, I am thinking that Imitrex is not the cause of my extended cycles.

Title: Re: Imitrex and rebounds
Post by Gator on Apr 22^nd, 2007, 1:03am

Well, I'm chronic, so the question about extending the cycle I can't answer. As far as rebounds or increased frequency/severity... For me, I don't see an increase in the frequency or severity of hits when I use the imitrex injections. Granted, I only use 1/2 shot most of the time, but there are times when I do the full dose stab and slam with the autoinjector. It just really doesn't seem to have any effect except relief.

I do have to say, though, those of you taking the various triptan pills to abort ch should really try either the imitrex injections or the zomig nasal spray. Either one gives me relief in minutes - that's single digits minutes.

Can't leave here without a commercial for oxygen as well. Combined with a clustermasx at 15 lpm I also usually get relief in the single digits with O2.

YMMV

Title: Re: Imitrex and rebounds
Post by Trooper on Apr 22^nd, 2007, 1:10am

I think that will be the next option for me. Tried the relpax, does not make me feel quite as crappy as the trex pill but does not seem to have the staying power either. My head has been throbbing all day long and I still had a second hit 12hrs after the first relpax pill. Not totally understanding how the O2 works and have a few questions about the shots too.

Title: Re: Imitrex and rebounds
Post by ClusterChris on Apr 22^nd, 2007, 7:47am

For me personally, I don't think it has extended my cycle. Been using imitrex for about 6 or 7 years and my cycles have pretty much stayed the same. about 6 hits a day. The way I look at it is, I would rather have a 2 month cycle while using imitrix and getting relief withing 10 minutes compared to having a 1 month cycl and only getting relief in 1 to 2 hours.

Title: Re: Imitrex and rebounds
Post by Bob_Johnson on Apr 22^nd, 2007, 11:38am

When you are thinking about things medical--don't think in terms of absolutes! Virtually nothing is true for everyone when it comes to the effectiveness, etc. of meds.

Man folks can use Imirex injection in massive doses without altering their attack patterns but other have changes. And on it goes for most meds--effectiveness, side effects, etc.

At best you take what you read here as guidance but if you and your doc and not ready to do intelligent trials of meds/doses, etc. you are likely denying yourself some helpful meds.

Seymour Diamond, M.D.--the old man of headache--used to say that any med had only a 60% change of being effective for any individual. That figure has gotten better over the years with some of the newer meds--but the idea still holds: Nothing is 100%.

Title: Re: Imitrex and rebounds
Post by pieface_49 on Apr 22^nd, 2007, 2:52pm

What are the experiences with the second generation triptans?

" * J Clin Pharmacol. 2002 Nov;42(11):1281-2; author reply 1282-3.

Current and emerging second-generation triptans in acute migraine therapy: a comparative review.

Deleu D, Hanssens Y.

Department of Clinical Pharmacology, College of Medicine, Sultan Qaboos University Hospital, Sultanate of Oman.

Sterile neurogenic inflammation within cephalic tissue, involving vasodilation and plasma protein extravasation, has been proposed as a pathophysiological mechanism in acute migraine. The action of 5-hydroxytryptamine (5-HT1B/1D) agonists--so-called triptans--on receptors located in meningeal arteries (5-HT1B) and trigeminovascular fiber endings (5-HT1D) has an inhibitory effect on this neurogenic inflammation. Recently, a series of second-generation 5-HT1B/1D agonists (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, and zolmitriptan) have been developed and are reviewed in this article. Their in vitro pharmacological properties, pharmacokinetics, clinical efficacy, drug interactions, and adverse effects are evaluated and compared to the golden standard in the treatment of acute migraine, sumatriptan."

http://www.zomig.info/Information/Triptans.aspx?l1=9

"The new generation of triptans are special because they are like a bouncer in a rough bar. When a fight or headache breaks out, they are there to halt further hostilities. Unlike many migraine medications that work only if they are taken when early signs appear, these new generation drugs can stop a fully launched headache cold. Even though they come only in tablets, their effects may last longer than sumatriptan."
http://health.discovery.com/centers-pain-headache-head_triptans.shtml

Article written in 1999
An interesting assessment of triptans from a medical view:
http://www.achenet.org/articles/dodick.php

Title: Re: Imitrex and rebounds
Post by Linda_Howell on Apr 22^nd, 2007, 4:42pm

Quote:

Another vote against Immigran. We don't have Immitrex in Saudi, or at least I can't find it.

Just in case this should come up in a Trivial pursuit game Jack....Immitrex and Imigran ARE one and the same. The name just changes as it leaves out shores in the US. lol

Linda

Title: Re: Imitrex and rebounds
Post by Guiseppi on Apr 22^nd, 2007, 4:50pm

I hate doing any cause and effect with this condition cuz there are just so many variables. That being said, I've never had a cycle go longer then 4 months, 2-3 has always been my average for the 30 plus years I've worked with it. I had my longest remission of alm ost 2 years, which I credited to my manesium, calcium, vit B-2 regimen.

I started my last cycle and finally decided to try imitrex jabs. Worked great, never failed me. It was my secondary abort, oxygen is still number on. But the cycle went over 8 months. I'll try and do without next cycle if I don't get creamed, and see what happens!

Guiseppi

Title: Re: Imitrex and rebounds
Post by testy01 on Apr 27^th, 2007, 4:23pm

on 04/22/07 at 16:42:20, Linda_Howell wrote:

Just in case this should come up in a Trivial pursuit game Jack....Immitrex and Imigran ARE one and the same. The name just changes as it leaves out shores in the US. lol

Linda

Linda

Thanks for that. I'm now up for Trivial Pursuits. ;;D Seriously though, I fear all the triptans these days. Every time I try to use them I wind up with more and bigger hits. Maybe the rebound effect, I dunno.

Jack

Title: Re: Imitrex and rebounds
Post by michael on Apr 27^th, 2007, 6:36pm

I have used imigran injections now for over 6 years for each cycle. I get a cycle once a year around feb/march for 6-8 weeks. For years my clusters were once a day for around 2-4hours. Since using the injections this frequency has changed to 4 times a day, however the cycle length hasn't changed. What has happened though is I now get about 4 headaches a week - I would call them hangover type headaches - between cluster cycles. An imigran radis tablet is needed to abort these headaches. So it seems I am on some form of tryptan permanently.

Title: Re: Imitrex and rebounds
Post by thomas on Apr 30^th, 2007, 5:15pm

on 04/17/07 at 22:59:28, UN solved wrote:

The $ 64,000 question ... does it extend cycles or make them worse ?

My answer is a resounding yes. For me, but it may vary from individuals. My last 3 cycles combined were less than 3 months in length, that is all 3 TOGETHER. With no 10's in any of the 3 cycles. Where as before, when I was taking trex, the cycles were 3-4 MONTHS in length EACH cycle. Now I've been pf for well over a year. So, for me getting off trex was the best thing I could have done, I haven't used it in over 4 years and these have been the best 4 years (ch pain wise) out of the last 14.

Title: Re: Imitrex and rebounds
Post by BlueMeanie on Apr 30^th, 2007, 8:04pm

I've used Trex for around 12 years and at first I thought it was making the cycle last longer. Now I know better. I've had short 8 weeks cycles and long 18 week cycles with only med being Trex & O2

As far as more hits a day. I agree. It seems anytime you try stopping the Beast, it returns until whatever it needs to accomplish is complete.

No meds = 2-3 hits a day
Trex = 4-5 hits a day
02 - 6-7 hits a day

I still prefer the Trex and 02 and taking more hits a day though. Pain is just too much to handle. ;)

Title: Re: Imitrex and rebounds
Post by billyjoe on Jun 7^th, 2007, 10:52pm

$64,000 question. For me, I'm not sure if it's it's too much Trex or too little causing more ch's the next day. I've been experimenting with the dosage and it appears that too little, or too much Trex, and it's worse the next day. I find that 3mg for my 1am CH works just right and leaves me feeling pretty good the next day. I try to use O2 for the other CHs. For some reason, O2 in the am doesn't cut it for me.

Title: Re: Imitrex and rebounds
Post by BMoneeTheMoneeMan on Jun 8^th, 2007, 2:26am

on 06/07/07 at 22:52:05, billyjoe wrote:

For some reason, O2 in the am doesn't cut it for me.

I hear you. In the morning when it is time to wake up and I get a hit, coffee is really helpful. Other caffeine would prolly help the same.

Title: Re: Imitrex and rebounds
Post by Wartooth on Jun 8^th, 2007, 9:44am

From my experience, it does not seem to extend the cycle, but it seems that when taking imitrex (statdose 6mg) it does seem that I get more throughout the day. However, it is a tradeoff as I can't seem to find anything else that rids me of them quickly. I did find that taking maxalt before getting one helps me get through the day. Night time is the worst.