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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Risks with regular use of triptans?
        
(Message started by: AT on Aug 17^th, 2007, 10:42am)

Title: Risks with regular use of triptans?
Post by AT on Aug 17^th, 2007, 10:42am

I'm only on my second episode of CH. I've been taking 2 doses of triptans every day for about a week now (in addition to verapamil). Is there any problems, side effects, risks, etc., with taking them every day for weeks at a time?

Title: Re: Risks with regular use of triptans?
Post by seasonalboomer on Aug 17^th, 2007, 11:01am

Are you taking them to abort a CH when it hits?
Do you have any known heart conditions?
Has your frequency of CH hits decreased with use of the Verapamil?
Do you have a doctor who would consider getting you a prescription for Oxygen? -- this can be used as an alternate abortive instead of the Imitrex everytime (if that is what you are doing -- it is nice to have more than one tool in the box when it comes to attacking back on these things)

Scott

Title: Re: Risks with regular use of triptans?
Post by AT on Aug 17^th, 2007, 11:08am

I'm taking triptans to abort the CH when it hits... My doc said oxygen would be the next thing we try. Anyhow, esp if you read the triptan leaflet, it sure seems like it's not intended for daily use. Are there any drawbacks to taking it every day for 2 weeks or more?

I have no known heart conditions. The verapamil is sofetning the pain and frequency of the CH, my neurologist said that was the best that could be hoped for. A few days this week I only needed to take the triptan once.

Title: Re: Risks with regular use of triptans?
Post by ClusterChris on Aug 17^th, 2007, 11:20am

I am certainly no doctor, so do not in any means go buy what I am saying here. I have been using the injections for the past 4 or so years. When I'm in cycle i use 2-3 vials a day for 4 to 6 weeks. I have not felt any side effects to date. But that doesn't mean it's not doing long term damge to the heart. I hate taking these damn things but as you know, The pain is just too intense to sit there and say, I'm not taking any more triptans. I suggest you talk it over with your doc if you have any concerns whatsoever. Pf wishes to ya!

Chris

Title: Re: Risks with regular use of triptans?
Post by Guiseppi on Aug 17^th, 2007, 12:21pm

I've been fortunate in that my prevent, lithium, and primary abortive, oxygen, have been very effective for me. I will only burn through 6-8 imitrex shots per cycle so I haven't had to worry about the long term use.

Try and get the doc to reconsider oxygen as the primary abort with trex as a back up. You know the trex works so it'll gve you the confidence to try the 02 first, knowing trex is always there to save you. It's cheaper and has no real side effects to worry about. Hoping the cycle is winding down for you and your remission lasts forever!! (What, we can always hope!!!! ;;D)

Guiseppi

Title: Re: Risks with regular use of triptans?
Post by seasonalboomer on Aug 17^th, 2007, 12:46pm

on 08/17/07 at 12:21:05, Guiseppi wrote:

Guiseppi is right on here! Having O2 (completely safe, no side effects) as the primary and then the "big gun" (Imitrex) as your back up is the right strategy. Been using it for a couple years and my life is changed as a result.

Scott

Title: Re: Risks with regular use of triptans?
Post by vietvet2tours on Aug 17^th, 2007, 12:55pm

Oxygen should be the first choice.Then everything else.

Title: Re: Risks with regular use of triptans?
Post by chewy on Aug 17^th, 2007, 1:26pm

First off..what triptan are you using?

Title: Re: Risks with regular use of triptans?
Post by AT on Aug 17^th, 2007, 1:53pm

First, thank you to everyone who is answering my question. This message board is a wonderful resource and I really appreciate the help. Nobody I know is familiar with CH and it is great to be able to chat with folks who know about it.

I have been using Relpax as I had a long business trip right when this cycle started, and the pharmacy could not confirm a question w/the doc's office for the injectable imitrex before I left. I now have the injectable imitrex to use, so far today I have not yet needed to use it.

Title: Re: Risks with regular use of triptans?
Post by Bob_Johnson on Aug 17^th, 2007, 2:04pm

Headache. 2004 Feb;44(2):178-82.

Frequent triptan use: observations on safety issues.

Robbins L.

Department of Neurology, Rush Medical College, Chicago, Ill. 60062, USA.

OBJECTIVE: To examine the safety of frequent triptan use over extended periods. For a small group of patients with refractory migraine plus chronic daily headache, triptans are effective. METHODS: This retrospective study primarily evaluated the cardiac safety of daily triptan use in 118 patients and, in addition, hematologic tests were assessed. Each patient had utilized a triptan for a minimum of 4 days per week for at least 6 months. Patients with rebound headache had been withdrawn from the triptans. Most patients (97 of 118) averaged 1 tablet daily; most would occasionally go for several days without a triptan. Forty patients had taken a triptan for 6 months to 2 years, 37 patients from 2 to 4 years, and 41 for 4 or more years. RESULTS: Routine hematologic tests were performed periodically on all patients, and no abnormalities were attributable to triptans. Almost all patients had an electrocardiogram, and no abnormal electrocardiograms were felt to be related to triptans. Cardiac echocardiography was performed in 57 patients. The 10 abnormal echocardiograms were not due to triptans. All 20 cardiac stress tests revealed normal findings. Adverse events were minimal; 9 patients described fatigue due to triptans, and 5 had mild chest tightness. CONCLUSION: This long-term study of 118 patients indicates that frequent triptan use may be relatively safe.

PMID: 14756859 [PubMed ]
====================================================================
Funct Neurol. 2000 Jul-Sep;15(3):167-70.

Sumatriptan overuse in episodic cluster headache: lack of adverse events, rebound syndromes, drug dependence and tachyphylaxis.

Centonze V, Bassi A, Causarano V, Dalfino L, Cassiano MA, Centonze A, Fabbri L, Albano O.

Dept of Internal Medicine and Public Medicine, University of Bari, Italy.

This observational study was designed to examine the pattern of sumatriptan use in patients with cluster headache using more than the recommended daily dose of subcutaneously injected (s.c.) sumatriptan. Thirteen patients suffering from episodic cluster headache were asked to record the characteristics of their attacks and drug intake for 1 year. All reported a high daily frequency of attacks (more than 3 per day) and the related overuse of s.c. sumatriptan. The results show that the overall incidence of adverse events among patients receiving sumatriptan injections for the treatment of cluster headache is low. The extended administration of this drug in episodic cluster headache did not result in tolerance problems or tachyphylaxis. Only 4 patients experienced minor adverse events and recovered more slowly than the others. They suffered from migraine without aura and cluster headache, and showed a family history of migraine. Even though they must be viewed with caution, due to the observational nature of the study and the low number of patients included, these results suggest that the profile of sumatriptan may differ in cluster headache compared with migraine.

PMID: 11062845

Title: Re: Risks with regular use of triptans?
Post by southwalessunshine on Aug 17^th, 2007, 4:57pm

I agree with alot of people here, try get the 02. I got it recently and part of my angle to get it was to play on the cost. We get free prescriptions here in Wales so the government picks up my tab for all my CH meds. I said that although 02 is expensive it would be alot less expensive than all the triptans I have been using thus far. The doc has to consider your quality of life and any drug regardless of long term side effects would be best avoided if possible. However 02 has no side effects and aborts quickly. try using the cost and quality of life angle with your doc. I've personally found that docs try use 02 as a last resort when they should see it as a first resort. Print out everything regarding 02 from this site, including message board conversations like this one and from OUCH and take it into your doc. Many doc's aren't clued up with CH in general and need us Chers to educate them, they may not like to be told how to do their job but how can they argue with cold, hard facts? good luck x

Title: Re: Risks with regular use of triptans?
Post by buhrly on Aug 17^th, 2007, 5:19pm

i 52nd the o2, my doc encourages that over trex as the first line of defense. cant hurt to see what he says.

Title: Re: Risks with regular use of triptans?
Post by chewy on Aug 17^th, 2007, 6:30pm

on 08/17/07 at 13:53:33, AT wrote:

I now have the injectable imitrex to use, so far today I have not yet needed to use it.

Then use the imitrex tip, Button on the left, and there shouldn't be an issue with extended use.

1/2 the standard dose will ussually knock out a banger for me.

Title: Re: Risks with regular use of triptans?
Post by LindsayLoo on Aug 17^th, 2007, 9:46pm

I am in just my second cycle of CH's too. Definitly try the O2, I was on 40 mg of Relpax 2x's a day everyday for 3 months (still am, as needed though) and the o2 works much faster than the pill. It didn't seem to help much because it was pill form obviously. I know getting o2 can be a major pain in the arse, believe me I went through hell to get it and just recently. I had to get myself admitted to the hospital for a week to finally get it approved. I have never tried the Imitrex injections but I do have the nasal spray and haven't noticed any problems except the normal side stuff like drainage and burning. Although, I noticed that with the spray I have lost some taste buds. *shrugs* Oh, also have been on Verapamil since june too.

Title: Re: Risks with regular use of triptans?
Post by rolo65 on Aug 17^th, 2007, 10:59pm

Be careful with the triptans! A little now and then in an emergency is one thing. Thinking you should take them all the time will put you in rebound hell! The less the better or they (the triptans) become less effective and you just end up getting desperate. Love your oxygen and it will love you back! ;)

And by the way Chris, quitting the triptans will slow down your attacks. Did your doc tell you to do 3 6mg vials a day for 6 weeks straight? I’m sure you know the limit is @ 2 per day for 3 day a week max. I’m glad your ticker is still working. ::)

Title: Re: Risks with regular use of triptans?
Post by DannyV on Aug 18^th, 2007, 8:20pm

For what it's worth, I use an average of 2 shots a day of Imitrex and have been for over 5 years. No side effects at all. No rebound headaches. Nothing but relief.

Title: Re: Risks with regular use of triptans?
Post by UN solved on Aug 18^th, 2007, 10:37pm

on 08/18/07 at 20:20:52, DannyV wrote:

For what it's worth, I use an average of 2 shots a day of Imitrex and have been for over 5 years. No side effects at all. No rebound headaches. Nothing but relief.

Same story here, but I used as many as 8 jabs a day for years ... no side effects except relief :) (And it's never lost it's effectiveness)

"Do as I say, not as I do!"

Goodluck

UNsolved

Title: Re: Risks with regular use of triptans?
Post by Ray on Aug 18^th, 2007, 11:31pm

I too have used up to 8 half doses of Imitrex shots in a 24 hour period. I'm almost up to 24 hours without a headache, but the preceeding 24 hours I had 8 CH and 6 jabs. I've been using this drug since it came out, '93 I think. I feel as though I should be on the Glaxo calendar, or at least mentioned in the quarterly reports.....

sigh

Ray

Title: Re: Risks with regular use of triptans?
Post by seasonalboomer on Aug 19^th, 2007, 6:25am

on 08/18/07 at 23:31:08, Ray wrote:

I've been using this drug since it came out, '93 I think. I feel as though I should be on the Glaxo calendar, or at least mentioned in the quarterly reports.....

sigh

Ray

Or, maybe some old ladies sewing quarterly as a pin cushion........

;)

Scott

Title: Re: Risks with regular use of triptans?
Post by UN solved on Aug 19^th, 2007, 12:35pm

on 08/18/07 at 23:31:08, Ray wrote:

I feel as though I should be on the Glaxo calendar, or at least mentioned in the quarterly reports.....

LOL ... I can picture it now ... their profit charts directly correlates to the cluster cycles. !! Up when we're in cycle and down when In remission :P

UNsolved

Title: Re: Risks with regular use of triptans?
Post by AT on Aug 20^th, 2007, 12:37pm

Wow. Thanks to everyone! I have gone back and re-read the posts over and over again. When my doc first mentioned oxygen I had my doubts and agreed on going with the imitrex injections first, yet I now plan on asking for the O2 when I see him next. Thanks again for all the info -- it's very reassuring, and I was in a great need for a little reassurance.

Title: Re: Risks with regular use of triptans?
Post by seasonalboomer on Aug 20^th, 2007, 2:00pm

on 08/20/07 at 12:37:01, AT wrote:

Let me encourage you to not simply "ask" for Oxygen, but be prepared to demand it. Be prepared to shame the doctor into giving it to you (eg. Why would he want to do deny you what is the best first line tool of fighting CH?) Print a picture of Jonny (tatt's and long hair version) and tell him that Jonny is a specialist you may have to bring in to help make sure that your doc is giving you the right course of options.... (just kidding on that one
;) )

Scott

Title: Re: Risks with regular use of triptans?
Post by brauer100 on Aug 26^th, 2007, 4:16pm

I had a doc who told me I could use them every day, and at first they worked like a charm, so I used them every day for a while. Eventually, I ended up in rebound headache hell and it took me a couple of months to shake the headache.

I continued to use them frequently, albeit not as frequently, and now for some reason I cannot use them at all. They make my head explode when I take them. One shot of Imitrex and my head feels like a rocket popping into a horrible explosion. It sucks, because I've lost what might have been a useful tool.

Obviously, that's not everyone's experience. Just mine. I don't know if that happened to me because of overuse, but I suspect so.

O2 is great, though. So is Red Bull. I've found I have to drink two of them in a row. Not quite as effective, but it's a nice quick fix if you don't have time for O2.

Good luck.

Kate