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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> NORTRIPTYLINE
        
(Message started by: PaulAnd on Mar 11^th, 2008, 2:50am)

Title: NORTRIPTYLINE
Post by PaulAnd on Mar 11^th, 2008, 2:50am

Hi everyone,
im Paul a newbie with CH i have been prescribed nortriptyline by my neuro but am confused can anyone help me as i cant find much info about them

thanks

Paul

Great site

Title: Re: NORTRIPTYLINE
Post by mummymac on Mar 11^th, 2008, 3:40am

Hello Paul

Welcome to Clusterville. I cannot help you as I do not have much knowlage ( and I am supposed to be working) with the meds. BUT there will be someone here who knows.

I am sure someone will be along very soon to help you out with information.

They are a usally a great group of people willing to give what ever help they can.

Hoping you have a PFD and I am back to work
Toodle loo

Tanya

Title: Re: NORTRIPTYLINE
Post by darknight on Mar 11^th, 2008, 6:57am

Hi Paul,

Hope this helps
http://en.wikipedia.org/wiki/Nortriptyline

its mainly used as an anti dep that has other uses! ;)

Title: Re: NORTRIPTYLINE
Post by Bob_Johnson on Mar 11^th, 2008, 8:24am

I'm not aware that Nort. has any track record to use with Cluster.

Print both of these articles and use them to discuss options with your doctor.

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: NORTRIPTYLINE
Post by jace77 on Mar 11^th, 2008, 8:35am

We ask the neuro about this and was told in his experience it was not helpful, though we have a friend with migraines and calls it her birth control for headaches.

Title: Re: NORTRIPTYLINE
Post by Gator on Mar 11^th, 2008, 8:51am

Don't be automatically put off by a drugs primary usage. Many drugs are used off-label to treat CH, especially since there are no CH specific medications available.

Anti-depressants are sometimes used to treat certain types of pain. My doctor prescribed nortriptyline and explained that it "altered the way the brain interprets pain" which in effect relieved the pain. My doc took me up to 200mg before moving on to something else. It didn't work for me, but neither has any of the other meds I've tried.

Amitriptyline is another anti-depressant commonly prescribed for CH. It has been shown to be somewhat effective in treating diabetic neuropathy, fibromyalgia and other chronic pain syndromes.

Of course, with CH, there is also the possibility of developing depression, especially during the worst of a bad cycle, so it couldn't hurt there, either.

I seem to remember at least one person here saying ti worked for them. Give it a shot.

Title: Re: NORTRIPTYLINE
Post by monty on Mar 11^th, 2008, 9:43am

Tricyclics meds can help some people - not generally a first line treatment for clusters, but if you are already on them, maybe worth sticking with it to see how it works for you.

Title: Re: NORTRIPTYLINE
Post by PaulAnd on Mar 11^th, 2008, 10:03am

Thanks for the info and so quickly
I still have more questions tho
is it ok to take with other meds
just finishing steroid taper (been on them for 5 weeks)didnt break the cycle just moved it to diff times of day , now back to nite time hits (two last nite both kip 8/9 for one hour each)
I take sumatriptan 100mg tablets chewed and washed down with a couple of red bull to try and abort (works sometimes)
getting o2 del today so i hope that will help as it seems to help so many others
Im told to take 1 x 10 mg nort and ramp up weekly to a max of 1mg/kg so thats 80mg which will take 8 weeks in my book.
are they addictive?
also i am flying to usa in 3 weeks for holiday (this scares me a lot)any info would be hugely appreciated

Paul

Title: Re: NORTRIPTYLINE
Post by Guiseppi on Mar 11^th, 2008, 10:26am

For the flight you're planing on taking, talk to your doctor about the imitrex injectables. I carry them when I fly, the TSA people have checked them a couple of times and don't have a problem with them. I don't like to use imitrex if I dont have to as it is expensive and i don't like some of the side effects. But thus far it has been 100% effective at stopping an attack in its tracks.

Good luck on the trip!

Guiseppi

Title: Re: NORTRIPTYLINE
Post by lionsound on Mar 11^th, 2008, 10:53am

Hey Paul,
I would ask your doc about what else you can take the nortrip with. When I took it I was told that it can enhance the effects of other drugs. It can also make you drowsy so I was instructed to take it at night to help me sleep.

A long time ago ,I took it as an add-on to anti-depressants and anti-seizure meds cocktail that I was taking for my HA's and depression. Initially it helped with my sleep, and i don't think it ever really helped my headaches or my mood.

Title: Re: NORTRIPTYLINE
Post by mummymac on Mar 11^th, 2008, 5:06pm

Paul

You need to get your doctor to give you Imergran Injections. These are like little miracles, they work in mins - very very fast, not like the tablets.

The Injections are the recomended treatment for CH, and being British you do not have the same problem as our American friends with the cost.

I went from tablets to Injections this cycle, I could not belive the differance they made.

Title: Re: NORTRIPTYLINE
Post by PaulAnd on Mar 11^th, 2008, 5:25pm

Doc has said he will give me injectables if i want them

I have got o2 today not had to use it yet but i think id like to go down that road first and see if it helps, rather that than meds
im a big scaredey cat

Paul

Title: Re: NORTRIPTYLINE
Post by mummymac on Mar 11^th, 2008, 5:49pm

I haven't used O2 , my Doc wouldn't give it, mostley everyone here says it is the bees knees and workes wonders, sometimes they say it needs to be backed up with Imergran.

The Injections are very easy to use, it is like a pen which you place against the chosen area and you just press a release button, just stings for a moment, but OH SO WORTH IT, with the release from the pain being so quick.

I hope and am sure the O2 will work for you but some injections at the ready just in case would't hurt (much), no need to suffer anymore than you have to

Title: Re: NORTRIPTYLINE
Post by Bob_Johnson on Mar 12^th, 2008, 8:28am

This med is especially useful when traveling because in a pill form. Has been very effective for several people here. IF you are currently having cluster attacks, you could get a sample from your doc and try it before you start your trip.
--------
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: NORTRIPTYLINE
Post by LeLimey on Mar 12^th, 2008, 9:56am

Paul your O2 company can arrange for you to have O2 while on holiday. Give them a ring! Who are you with? Unsure of the supplier on the IOW.

Make sure you get your doctor to give you a letter stating you use imigran injections in case you need it at customs. I never have and I have been to the US carrying a lot of it several times but it's better safe than sorry.
Customs can be a funny lot at the best of times! Also do not take any meds out of original labelled with your prescription packaging obviously.

Ask your doctor for some Frovatriptan for flying. It's a tablet triptan so take it a couple of hours before you fly (not within 24 hours of any other type of triptan though) It has a huge half life and will protect you for up to 26 hours. You can take 2 within 24 hours so it's ideal for travelling. It takes a while to kick in hence taking it beforehand.

You can't take liquids through security but you can buy them in the duty free lounge. Get yourself a couple of cans of red bull there and chug them at the first sign of a hit. Caffeine is a great vaso constrictor!

Finally, drink every time you are offered on the flight. Dehydration is the biggest cause of HA's in general so for heavens sake take every precaution against it!

If you havne't already arranged travel insurance I got mine through go travel, I mentioned CH so it was listed and I got an extremely low rate - well chuffed!

I hope this all helps. Check in with any other questions and we'll do all we can to get you looking forward to this holiday without fear!

Oh and get Mrs Pauland to come along and post too - bucketloads of support is waiting for her also.

Helen

Title: Re: NORTRIPTYLINE
Post by PaulAnd on Mar 12^th, 2008, 10:05am

Thanks everyone for all the info
going to get some injectables from the doc they dont sound too bad if they are like a pen.

Had o2 last nite for the first time WOW its brilliant to say the least 20 mins and completely gone then went back to bed and straight to sleep what a difference.
I am now wanting to see if its possible to have some available on the plane and during my stay.

Thankyou again

Paul

Title: Re: NORTRIPTYLINE
Post by LeLimey on Mar 13^th, 2008, 11:46am

Nothing is such a "fix" for me as seeing someone get it with O2 - you can't put a value on that incredible feeling can you?!

Thank you for telling us that, it's a real joy to hear :)