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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Newbie question about IMITREX in pill form
        
(Message started by: Kimberly on Dec 1^st, 2007, 11:07am)

Title: Newbie question about IMITREX in pill form
Post by Kimberly on Dec 1^st, 2007, 11:07am

Hi --

Please excuse my ignorance if this is a no brainer... I feel like I'm moving in slow motion these days when life is still moving at fast forward :-/

Currently, my neurologist has me taking Topamax, Elavil and Indomathacin. Last week he also gave me a script for 100 mg IMITREX pills and said to take it at the onset to see if it would head off/lessen a particularly bad attack. I've read a lot about IMITREX injections on this website and am curious if anyone has had similar success with IMITREX in the pill form.

Also, I was wondering if the pill form carries the same possible side effects (i.e. rebound headaches, etc) since it is prescribed in a dosage of 1 with a follow-up of 1 after 2 hours with no more than 2 in a 24 hour period.

I'm just curious .. I know I should have asked my neurologist when I was there .. I always forget what to ask <sigh>.

Thanks in advance. Kimberly.

Title: Re: Newbie question about IMITREX in pill form
Post by Bob_Johnson on Dec 1^st, 2007, 11:27am

My first reaction: you doc is not up todate on treating Cluster headache. That may no be fair but my reasoning:

1. Pills don't work well for cluster because they take so long to become effective compared to the very rapid development of Cluster.
2. Imitrex does work to "ward off" an attack. This is close to him suggesting that it could be used to prevent--but it doesn't. For most folks here, Imitrex injection is one of the best abortives.
3. Elavil doesn't help cluster; Indo is not for cluster but effective for a variation which is more rare yet than Cluster. (I'm assulming the Dx was Cluster. Was something else mentioned?)

Suggest you print out these two documents and gave a copy to the doc. Use it as a tool to engage a discussion of options--rather than questioning his Rx. Not wise to criticize an M.D. directly. <bg>
=======
HERE ARE TWO MAJOR DOCUMENTS WITH RECOMMENDED TREATMENTS FOR CLUSTER HEADACHE, ONE FROM A U.S. PHYSICIAN, THE SECOND FROM EUROPE.
_________________________________________
http://www.plainboard.com/ch/chtherapy.pdf
Here is a link to read and print and take to your doctor. It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S. (2002. Rozen)
================
Treatment guidelines from Europe

------
A. May, M. Leone, J. Áfra, M. Linde, P. S. Sándor, S. Evers, P. J. Goadsby:
EFNS guidelines on the treatment of cluster headache and other
trigeminalautonomic cephalalgias.
European Journal of Neurology. 2006; 13: 1066–1077.

Download free full text:
http://www.efns.org/files/guideline_49.pdf
(Thanks to "cluster" for link.)

Title: Re: Newbie question about IMITREX in pill form
Post by Charlotte on Dec 1^st, 2007, 11:28am

I found tablets only worked if you have warning signs like tingle in the chin or lip 20 minutes before you get hit, then there is enough time for it to get into your system. I found 25mg worked better than higher doses. However, if you have no warning signs, my opinon is that it is useless.

His instructions for using them sound like for migraine. CH is different. If you still have it in 1 hour, it didn't work. In 2 hours, it could be the next headache.

Maxalt melt is a rhizatriptin tablet that melts in your mouth. I use them, under my tongue and they work for me.

Triptin sprays work better, and shots work better than that.

As for Indomethacin, many people find it doesn't help, but I have additional TACs and for me it does help, in addition to my verapamil. My Indo dosage is very low, 25 mg, 4 times a day, cut back from 300 mg and working just as well.

Charlotte

Title: Re: Newbie question about IMITREX in pill form
Post by E-Double on Dec 1^st, 2007, 11:35am

completely agree with Bob!!!! (as always)

Indomethacin did nothing for my clusters yet did keep another HA type at bay (idiopatic stabbing headache)
It was a bitch to come off of!!!!

good luck

Title: Re: Newbie question about IMITREX in pill form
Post by Shedz on Dec 1^st, 2007, 12:12pm

Hi Kimberly, I used to be presrcibed the Imigran/Imitrex rapimelt tablets and found that by the time they got into your system the CH was over. I now use the injection kits which are so much better. 02 works extremely well as an abortive too. When I feel a hit coming on I use caffeine/taurine drinks to try and abort it, works very well if used early enough.
Hope this is of some help to you.

Paul.

Title: Re: Newbie question about IMITREX in pill form
Post by Kimberly on Dec 1^st, 2007, 1:54pm

Wow!! Thank so much for all the good info!

When I started keeping a headache log for my neuro, I noticed that it was pretty much like clockwork that my headaches came on with the slightly worse pain in mid afternoon and the mid morning.

I didn't have any migraine associated indicators but my neuro suggested that I try the IMITREX pill (along with the other scripts I was already taking) during the time when I have my indicators that an pain episode is beginning (stabbing and/or burning pain beginning behind the right ear/eye) But when I took the Imitrex pill, I didn't notice any change.

I'm in my 4th wk of a pain cycle now averaging btwn 6-8 episodes 60-90 mins long each day. It has pretty much shut me down from from most of the real world once again as this is the 2nd time this has happened to me. The first time was 3 years ago to the day. That one lasted about 7 weeks and when it ended, I brushed it off as a fluke but now I know better <<sigh>>. If nothing else, I'm looking forward to this one being over half way over already :-/

I know this is probably nothing compared to some of the horrific suffering that some of you have been through for years (!!) but I'm open to any words of wisdom that you might be able to offer.

Kimberly.