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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Gabapentin in Chronic CH
        
(Message started by: Bob_Johnson on Jun 7^th, 2007, 12:10pm)

Title: Gabapentin in Chronic CH
Post by Bob_Johnson on Jun 7^th, 2007, 12:10pm

Eur J Neurol. 2007 Jun;14(6):694-6.

The use of gabapentin in chronic cluster headache patients refractory to first-line therapy.

Schuh-Hofer S, Israel H, Neeb L, Reuter U, Arnold G.

Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.sigrid.schuh-hofer@gmx.net

Chronic cluster headache (CCH) is a rare but challenging condition. About 20% of CCH patients get refractory to treatment. Gabapentin has recently been reported to be efficacious in the treatment of CCH. To test the potential of gabapentin as second-line drug, we prospectively studied the efficacy of gabapentin as add-on drug in eight patients suffering from CCH refractory to first-line treatment. Six of eight CCH patients responded to treatment. After the end of the study phase, the patients' clinical course was further followed up until January 2006. The longest period of being continuously pain-free under gabapentin treatment was 18 months. In some individuals, increasing doses were needed with time. We conclude that gabapentin may be offered as treatment trial in patients refractory to first-line treatment. However, patients may fail to respond to treatment and drug tolerance may occur with time.

PMID: 17539953 [PubMed

Title: Re: Gabapentin in Chronic CH
Post by clavers on Jun 22^nd, 2007, 12:19pm

What dosage? I am already on 1200mg a day and no good results.

Title: Re: Gabapentin in Chronic CH
Post by taraann on Jun 22^nd, 2007, 7:54pm

Tried it (can't remember the dose) and it didn't work.

Title: Re: Gabapentin in Chronic CH
Post by purpleydog on Jun 23^rd, 2007, 10:33am

Neurontin affected me like Dopeymax (Topomax). Loss of short term memory, I had to stop taking it. It was affecting my job.

I know it has worked for some, and that's great. It just didn't work for me. I'm like you, TA, most meds haven't worked. Right now, I'm on Verap, trex, and O2.

Title: Re: Gabapentin in Chronic CH
Post by Redd on Jun 23^rd, 2007, 10:36am

Raises hand in the "didn't work" catagory. :-/

Title: Re: Gabapentin in Chronic CH
Post by Gator on Jun 23^rd, 2007, 7:07pm

Thanks Bob. I'll add this to the Gabapentin page on the OUCH website.

http://www.ouch-us.org/medications/gabapentin.htm

In the article, they speak of gabapentin being used as a second line medication as an add-on drug. To me, this reads like it is being used in addition to another medication, but they don't mention what that other medication is. Surely, if this is the case, the name(s) of other medication would be important to know. Kind of like for some people, neither Verapamil nor Lithium work, but when they combine the two, they get relief.

[raises hand] Gabapentin didn't work for me, either, but then neither has anything else. >:(

Title: Re: Gabapentin in Chronic CH
Post by Brewcrew on Jun 23^rd, 2007, 7:19pm

Worked for me for a short time (3 weeks). I was at 1200 mg per day, and with the zombie side-effects, I didn't want to go any higher.

Title: Re: Gabapentin in Chronic CH
Post by mynm156 on Jun 25^th, 2007, 8:07am

I wish you luck I had no luck with it not to mention freaky reaction to it.

Good Vibes MYNM156

Title: Re: Gabapentin in Chronic CH
Post by cluster on Jul 5^th, 2007, 6:21am

Just to get a better picture: ;;D

http://www.charite.de/kopfschmerz/images/kontakt_3.jpg http://www.charite.de/kopfschmerz/images/kontakt_5.jpg

Dr. med. Sigrid Schuh-Hofer Dr. med. Uwe Reuter

For more pics click here (German): http://www.charite.de/kopfschmerz/html/kopfschmerzambulanz.html

Quote:

In all patients, gabapentin was added to the current prophylactic drug(s) and was step-wise increased to 900 mg daily (increase of 300 mg every third day). In case of insufficient treatment response within 8 weeks, the drug was further increased – dependent on efficacy and tolerability. The pre-defined primary endpoint of the study was 50%, reduction of attack frequency, 4 months after having started gabapentin treatment.
[...]
After the end of this study phase, patients remained at our Outpatient Department and were regularly followed up until January 2006. Within this follow-up time, patients could transiently (maximum 14 days) add oral corticosteroids in case of exacerbation of CH attacks. If required, the dose of gabapentin was further
increased up to 3600 mg daily maximum.

Source: Schuh-Hofer S, Israel H, Neeb L, Reuter U, Arnold G.: The use of gabapentin in chronic cluster headache patients refractory to first-line therapy. Eur J Neurol. 2007 Jun;14(6):694-6.

Current prophylactic drug(s) of the eight patients were:

* Verapamil, corticosteroids. Since 09/03: verapamil + lithium 11/04
* Methysergide, verapamil, lithium. Since 02/03: verapamil + lithium 07/05
* Verapamil, corticosteroids. Since 02/04: verapamil + lithium 01/05
* Methysergide, pizotifen, corticosteroids, verapamil, naratriptan. Since 10/02: verapamil
* Verapamil, lithium, ergots, valproate, corticosteroids. Since 03/03 verapamil
* Verapamil, verapamil + lithium, valproic acid + lithium. Since 05/04: verapamil
* Verapamil. Since 04/04: verapamil + lithium
* Corticosteroids. Since 08/05 verapamil monotherapy

Gabapentin was added to the prophylactic drugs used at the time-point of study inclusion.

pf wishes,
Friedrich

Title: Re: Gabapentin in Chronic CH
Post by black on Jul 6^th, 2007, 10:42am

i am taking nowdays isoptin 320mg (4*80mg) and 600mg(2*300) Gabapentin as a secondary therapy.i keep a log and in 45 days i had 62 crisis.i believe it hasnt reduced the tense as i have to take imigran,zomigon or xeforapid as painkillers but i dont have 2 or three hrs headache.it has been reduced to 1h 30 min max.that is good but still in process.

Title: Re: Gabapentin in Chronic CH
Post by cluster on Jul 9^th, 2007, 5:12am

Hello Black,

sorry to read that you have to suffer so much.

Regarding Gabapentin:

Quote:

... and was step-wise increased to 900 mg daily (increase of 300 mg every third day). In case of insufficient treatment response within 8 weeks, the drug was further increased – dependent on efficacy and tolerability. [...] If required, the dose of gabapentin was further increased up to 3600 mg daily maximum.

Perhaps your doctor could allow you to increase the dose of verapamil or the dose of gabapentin or both ?

Many of us take more than 320mg/day verapamil.

In the gabapentin study a daily dose of 900mg up to 3600mg per day was given. You are on 600mg/day?

But please don't change your medication yourself: Ask the doctor!

pf wishes,
Friedrich

EDIT TO ADD: What about oxygen, do you have oxygen for acute treatment?