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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Imitrex 5mg vs 20mg
        
(Message started by: findjoshua on Aug 13^th, 2007, 2:22pm)

Title: Imitrex 5mg vs 20mg
Post by findjoshua on Aug 13^th, 2007, 2:22pm

Hi All. After a decent reprieve (well, not decent enough really) the ch's are back. I have tradtionally taken Imitrex nasal spray 20mg, but can't get enough via insurance to last through a cycle. I could get my doc to prescribe the 5mg so my insurance would pay for more. I started out on 20mg do not sure if 5 will work but if it does, there's nothing wrong with stepping down a dose right? Haven't called my doc yet, just curious.

Title: Re: Imitrex 5mg vs 20mg
Post by Bob_Johnson on Aug 13^th, 2007, 3:20pm

My sense of messages here is that 5mg is not sufficient for CH--but getting one bottle to try is worth a trial. No inherent problem is trying and you will know quickly whether it works for you.

If $ is a driving concern, you might ask your doc for a sample of this pill. Number of us have had good experience and the cost per dose is much less compared to Imitrex.
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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: Imitrex 5mg vs 20mg
Post by Maffumatt on Aug 13^th, 2007, 4:28pm

Read OUCH's june issue.

Title: Re: Imitrex 5mg vs 20mg
Post by Xenoz on Aug 14^th, 2007, 10:03pm

Pills never did anything for me.

5mg nasal spray didn't do anything for me. 20mg worked after about 15 - 20 minutes.

But the 20mg nasal spray only worked for me if my nostril was not congested - of course, the CH's tend to make me congested.

I did discover that it doesn't matter which nostril you use - I get my CH's on the right side, so that nostril tends to be more clogged. Tried 20mg in the left nostril, which was clear, and it worked just as well.

When both nostrils are congested I use the Imitrex injection.

But I try to avoid using Imitrex (in any form), partly because of the cost (and the fact that insurance companies somehow don't understand cluster headaches), partly because I don't like how it makes me feel the next day (particularly the injection).

Acting at the first sign of attack by chugging a Red Bull then getting on 12 - 15 lpm of oxygen for 15 minutes is my first line of defense, and I have actually managed to stay off the Imitrex for three weeks now.

It's possible that 5mg may work for you - everyone's different. Less meds is always better, so perhaps worth a try.

I imagine that perhaps 5mg nasal spray, a Red Bull then oxygen might be a good combo to try.

-Xenoz