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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Can Imitrex Cause Rebound HA's?
        
(Message started by: RAJ on Mar 31st, 2003, 3:17pm)
Title: Can Imitrex Cause Rebound HA's?
Post by RAJ on Mar 31st, 2003, 3:17pm
My cycle is currently running one month longer than ever before and I find myself wondering if I'm in a rebound mode from Imitrex.  Does anyone have experience or know if this is possible.  O2 and Trex still provide relief.  I'm half tempted to stop treatment to stop this madness, but don't think I could do it.  I am so tired of this &%$#.  Any input appreciated.  Thanks.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Ueli on Mar 31st, 2003, 3:31pm
    No



See:   http://www.clusterheadaches.org/library/medications/imitrex_rebound.htm
Title: Re: Can Imitrex Cause Rebound HA's?
Post by amber on Mar 31st, 2003, 3:46pm
but ueli.... ;)

can't you get dependant on it, causing an increased need for the medication?  I have read some info on that an sumatriptan.

I know that my doctors were concerned that I was using it too often and that it was indeed causing some of my headaches.

signed,
concerned headacher  ::)
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Nathan on Apr 1st, 2003, 9:22am
i had serious rebound headaches from imitrex nasal so my neuro took me off of it. of course, i had to use it daily, at least one a day if not more. people that are able to use it as directed (no more than 3 times per week) should have no rebound effect.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Wendy1 on Apr 1st, 2003, 2:00pm
When I took Imitrex about 6 yrs ago, I had a h/a EVERY 3-4 HRS vs. my nightly 1 or occaisionally 2.  Never before had I had so many and at times (during the day) that I had never had before.  My doctor took me off it because it is VERY UNSAFE to use that much in 24 hrs ~ you'll have a heart attack!  Incidently ~ Imitrex worked WONDERS for me.   :(    My opinion in my case it was DEFINATELY REBOUND!
Title: Re: Can Imitrex Cause Rebound HA's?
Post by achinghead on Apr 1st, 2003, 5:00pm
how much are you taking and how often.. Im going through 2 -6mg vials a day.. sometimes they last 2 days.. Im using the imitrex tip on the left and Im getting 2-3 per vial.. I hate using that much esp since Im paying outta pocket... but if I dont Im afraid I wont be here.. Cant deal with the pain.. anyhow.. Im beginning to wonder the same thing my self.. I just got 02 today so Im gonna try it and hope it works.. I just have so much trust in the trex that its hard to trust anything else.. we will see.. Im keepin my fingers crossed that it works for me.. let me know how much of the trex ur using
good luck
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Wendy1 on Apr 1st, 2003, 7:05pm
Well at the time I did not know about the Imitrex 'tip'.  It was really hard for me because it took my h/a away, but I had so many bruises from the injections, it was almost embarrassing.  The fact the I could die and was getting MANY MORE outweighed the fact that it helped my h/a.  Right now I'm taking Verapamil, Amerge and Vicodin and sitting with the beast for an hour.  I'm dieing, right now the beast has complete control over my days!!!! AAAAHHHHHHHHHHGGGGGGGGGGG
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Ueli on Apr 1st, 2003, 7:41pm
Something about rebound and dependence.

It is a well known fact that many OTC pain meds as well as narcotic pain killers can use rebound headaches. When used on a regular basis these meds enter the brain and on reducing them again withdrawal effects manifest themselves as a continuos headache, the rebounds. These rebound headaches are usually less severe than the one that led to the overuse of painkillers, but are annoying through steady presence.

Imitrex, and all the other triptans, act as vasoconstrictors. Their lifetime is so short that they never enter the brain and therefore have no addiction potential. This short life is also the cause that 2 hours after an Imitrex shot another attack may raise its ugly head. And that it is: another attack, nothing at all to do with a "rebound".

Wendy1, the fact that in one cluster bout you had more attacks than in others is something many clusterheads experience. The fact it was the bout you took Imitrex is not sufficient to postulate a correlation; or did you go in between a few days without Imitrex and the number of attacks dropped?

Now the old question, how much Imitrex is save take. As I have said often before, to get FDA approval the manufacturer must show the safety for the typical user, and 4 per month a more than enough for the typical meegrainer. Some insurance companies try to interpret this as an upper save limit, for an obvious reason. Likewise, some doctors want to save their ass by an unreasonable restriction. There are many clusterheads that have taken a hundred Imitrex shots in a month, and are still kicking.

What about he danger of heart disease? Here the answer is very easy: For people with certain heart conditions Triptans of any kind are a no-no. For people with a healthy heart there is no hint in the literature that even extended Imitrex use does favor the development of heart diseases.

If you had opened the link I gave in my first post, you had read about the lack of rebounds from Imitrex (and even its use to get red of rebound from pain meds), about the "overuse" and lots more. ;D
For your convenience, here's the link once more:

OUCH Library: About Imitrex Rebound (http://www.clusterheadaches.org/library/medications/imitrex_rebound.htm)

And while you there, take a look around, BobP has collected a lot of useful stuff in the OUCH research library.

PFNADs
Ueli
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Wendy1 on Apr 2nd, 2003, 7:48am
Ueli....

My cycles (20+ yrs) have always been pretty predictable.  Only with the Imitrex did I have them coming 3-4 hours after the imitrex ~ out of nowhere.  There is no doubt in my mind it was caused by the imitrex.  I have had 3-4 cycles since and have not had them as frequent.  I did read the bit about Imitrex and rebound.  a) any one other than the pt will not admit to rebound.  b) call it what you may, I believe some ppl do receive a rebound effect from Imitrex ~ others may not.

Trust me, I have researched just about e/thing there is to research and been to every h/a clinic in the east.  Thanks for your input though.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by RAJ on Apr 2nd, 2003, 7:51am
Ueli,
My apologies for overlooking the link you posted originaly.   Thank you.  

My confusion lies from other information indicating it is possible with migraine folks.  The paragraph posted below is from a website for Dr. David Haas of SUNY.  Most of the stuff I have found suggests it can for migraines but not for cluster.  (Hence my confusion).  


http://www.upstate.edu/neurology/haas/hpaadx.htm
Folks who take analgesics, ergotamine, triptans, or any other type of drug frequently for several consecutive weeks to alleviate migraines or episodic tension-type headaches risk inducing a chronic daily headache.

I utilize the trex tip from this site and find that 3mg is sufficient almost all the time.  This is particularly helpful as I have reached my limit with my insurance (started the appeal process).  I have taken up to four 6mg doses in one day with no problems but very much try to stay in the 2 to 3 range.  Once again I'm hoping that I'm nearing the end of this cycle as I'm down to two attacks per day and O2 alone helps with the moderate one which is 5 am.  The 1am attack is still to severe.

Wendy1:  My personal experience with Vicodin is not a good one.  While effective in providing relief, albeit slow to take effect, I have no doubt that "for me" it caused a rebound situation.  Many, many years ago, I had to have in-patient DHE treatment to break a cycle which developed non stop migraine on top of CH.  Never going there again!  Be careful.

Best of luck to all.  "May it pass quickly!"
RAJ
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Wendy1 on Apr 2nd, 2003, 7:58am
RAJ ...
FORTUNATELY for me, I have been lucky enough that Vicodin does not cause a rebound.  You're right it was an hour+ this am, but at least I know the pain will be gone in an hour.  I am out of my Amerge, my gp is out of town and my F------ neuro won't see me until the 14th (what's with that!!).  I am working very, very hard on relaxing and pressure points right now.  (Remembering 'we do not want to go to ER,  we do not....) LOL.  I am absolutely dying with these things right now...  

ANY SUGGESTIONS ANYONE!!
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Lenny on Apr 2nd, 2003, 8:30pm
According to my doc ( and he is very familiar with our disorder and well known) ,"YES", imitrex can cause rebounds,
I for one love (trex) its the only thing out there that will help me as far as aborting the beast. In the past i have used it on many occasions 6-7 times in a 24 hour period with no ill effect ( full 6-mg.each time ),the past 2 years i have been using 2-mg.each time( works just aswell as 6-mg.- sometimes takes a little longer,thats alright as long as it does the job ).
Of course GlaxoWellcome does not have that in their literature ::) ::) ( btw-this will help abort your headache-but dont use too much-it can cause rebounds = they are in it for the$$$$$  :o :o :o).I have been told by him atleast 4 or 5 times regarding this ( "that trex causes rebounds" ). As far as the literature ( bullshit ), just like( as an example ) "cluster-traits"( on this board )  saying that episodics cycles last 6 - 8 weeks and then goes into remission( when i was episodic,all of my cycles lasted from 8-9 months,each and every time) i guess what i am trying to say, dont beleive half the b.s. you read regarding our disorder ( all these so called "GURU"docs are still trying to figure it out. PFDAN to all.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by RAJ on Apr 3rd, 2003, 7:58am
Thanks for your input Lenny.
I too have found 2 - 3 mg to work...it does take longer, but it allows me to stretch the med, which is important as I am now in the middle of an appeal with my insurance company.  At least my Dr keeps me supplied with professional samples in the interim.  I have also found that with the lower does, my cycle may be coming to an end which might support the notion of some "rebound".  PFDAN to all.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cluster0557 on Apr 13th, 2003, 2:52am
Yes Imitrex has caused me rebound headaches. I cannot take it two days in a row.

So irregarsless of studies Uli mentions I know it does and have had to delal with it.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Ueli on Apr 13th, 2003, 10:14am
I wish not everybody would give a new definition, to his/her own liking, to a long established expression. Damn it.   :-[

There are cluster headaches and other headaches.

If you abort a cluster attack with an Imitrex shot, there can be different outcomes:
  • The attack is aborted for good; the next one comes several hours later, probably at the expected time.
  • The attack is aborted, but the same/another hits you after about 2 hours:
    • You aborted a monster attack that on it's own had lasted 3+ hours. Imitrex last only for about 2 hours, so it is possible that the original attack re-surfaces again.
    • A new attack starts. It is not unusual that 2 hours after the end of an attack another one starts.

So it could be someone experiences more cluster attacks when using Imitrex, but one thing is certain: these are NOT rebound headaches !

I assume y'all know the difference between a cluster headache and any other sort of headache. The term "rebound headache" is reserved for the low level, but continuous headache caused by overuse of painkillers, OTC or narcotic. Painkillers interfere with the transport and processing of pain signals, and can therefore cause a rebound headache. Imitrex works in an entirely different way than painkillers, and for this reason alone can not cause rebound headaches.

So, I we stick to the original definition of the words, it still holds:

Imitrex does not cause rebounds


PFNADs
Ueli
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cbolony on Apr 13th, 2003, 10:25am

Quote:
these are NOT rebound headaches !

Ueli you are right i use to think these were rebounds,but no rebound can cause the same CH 3-4 times a day at 8-10 kips for 4-5 weeks of my cycle and then start coming down to lower kips till the the cycle ends in about 8-9 weeks
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cluster0557 on Apr 13th, 2003, 1:13pm
Ueli,

I will agree to disagree.

My clusters are normally 6-7 hours (2-3 per day) between attacks.

If I use Imitrex 2 days in a row, (only twice a day) my clusters start occuring more often. Like every 3-4 hours (4-5 per day)

Now this in your opinion is not rebound. In my Neuro's and my opinion it sure seems like  a rebound.

I went back to maxalt for 2 weeks and no rebound symptom. Of course Maxalt and 20-30 minute abort time sucks so I am back to Imitrex and watching closely how much I use.

To minimize my non-rebound I went to vial and smaller dose and guess what.....................
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Bob P on Apr 13th, 2003, 8:06pm
Here are the symptoms of rebound headache:

daily or nearly daily headache

pain on both sides of the head

pressing/tightening quality ("like a tight belt around my head")

perhaps a mild degree of photophobia (sensitivity to light) or phonophobia (sensitivity to sound)

tight and tender neck and shoulder muscles

the patient is regularly taking symptomatic/abortive pain medication


Ueli is correct, a cluster headche is not a rebound headache, it's just another cluster headache.  Rebound headache is a specific headache with the above symptoms.  It is cured by stopping taking medications.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cluster0557 on Apr 13th, 2003, 8:20pm
hey you win the contest.

OK isn't the climical definition of rebound.

Answer me this. Why fo they reccomend limiting triptans to x days use a week?

Every quack Neuro I have seen has said rebound but heck I am a rookie what do I know  ::)
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Ted on Apr 13th, 2003, 9:04pm
I have a suggestion 0557. You're asking questions that you can find the answers to by clicking on the buttons to the left of the board or hitting the OUCH library. Why not just do that instead of giving an attitude to those trying to teach you so you don't have to do your own legwork of researching. And yeah. When it comes to certain headaches, some here are much more informed then many neuros, including those you're giving an attitude to.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cluster0557 on Apr 13th, 2003, 9:36pm
Ted,

Someone is very sensitive today. If that was giving attitude ok I will reserve my comments and when I disagree I will remember freedom of speech is not tolerated here.

When I thought about my "rebounds" I realized I did not get into what types of HA I have.

To UELI and BobP I apoligize.  My own research says you are correct in the clinical sense.

For me frequent use of Imitrex seems to bring on Migraines, not clusters with me. According to my Neuro he called this rebound and that is what I was quoting.
The OUCH study seems to support that.

To UELI and BobP again thanks for correcting my misinterpretation.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by eyes_afire on Apr 13th, 2003, 9:49pm
Hi Cluster0557.  The main reason for the dose limit is because during clinical trials the drug company didn't set up the study to include more frequent dosing.  Since imitrex is primarily marketed as a migraine medicine there was no reason for the drug company to set up the clinical trials for every-day dosing (or more).  Clinical trial applications are submitted to the FDA based on the intended usage of the drug product.  Therefore, some docs are reluctant to prescribe it more frequently, not necessarily because it is unsafe, but simply based on the clinical trials.

Another thing to consider... many of the insurance companies would love for us to believe that imitrex causes 'rebound cluster headaches' (if there is such a thing) because it gives them an excuse for limiting what they would pay for.  If your medical and prescription plans are covered by the same company, maybe the insurance company is pressuring the doc to limit imitrex prescriptions.  Who knows.

In my opinion, a doc that argues to limit imitrex due to fear of true rebounds (as per Ueli's description) is not being reasonable since the CH if MUCH WORSE than any rebound.

Now, having said that, it would not surprise me if after much use of imitrex, maybe the body becomes 'used to it' and maybe more frequent doses would be required.  Such an occurence would probably more properly be called 'a worsening of the CH condition' rather than 'rebound headache'.

Such are the pitfalls of being the victim of an 'orphaned disease'.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cluster0557 on Apr 13th, 2003, 10:17pm
Hi eyes_afire,

I am lucky because I don't have a predetermined limit per month on Imitrex or Maxalt. My Neuro has given me scripts to cover both in the needed quantity per month. For me it is only a matter of deductibles. I used to use Maxalt but have been using Imitrex since I went chronic a long while ago;

As to amount typically reccpmended per day and week you hit the nail on the head. The clinical trials for migraine said x pills per day to not exceed y pills per  week. And as you so eloquently stated those trials did not apply to cluster even though Imitrex is the # 1 abortive for Cluster.

Thanks for getttng my mind functioning again.


on 04/13/03 at 21:49:37, eyes_afire wrote:
Another thing to consider... many of the insurance companies would love for us to believe that imitrex causes 'rebound cluster headaches' (if there is such a thing) because it gives them an excuse for limiting what they would pay for.  If your medical and prescription plans are covered by the same company, maybe the insurance company is pressuring the doc to limit imitrex prescriptions.  Who knows.

Such are the pitfalls of being the victim of an 'orphaned disease'.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by RAJ on Apr 14th, 2003, 7:10am
Perhaps my next posting should be:  "Are CH patients typically Type A personality and highly opinionated?"  Geez folks....we share the same burden.  Be willing to share information and even an opinion, but don't beat someone over the head with it let alone demean them for their postings.  Everyone needs to remember these are just opinions, albeit highly educated ones.  Sure there are a lot of quack neuro's out there, but there are also a lot of highly trained competent ones.  Someone visiting this site that is looking for more than an opinion needs to seek out a competent neuro.  I asked my neuro this question when I visited him last Thursday.  He is certified in neuro & pain management, previous instructor at John's Hopkins and runs a HA clinic with quite a bit of CH experience.  He believes that any abortive medication can cause rebound and imitrex certainly can present elements of this.  As mentioned above, rebounds are distinctly different from CH.  My experience (and I stress; my experience) is when I'm coming to the end of my cycle, the CH attacks begin diminish in frequency and I begin to experience some rebound "head" pain (KIP 3-5/dull in nature).  Once the CH cycle is over, I begin to eliminate all pain meds to get rid of the rebound.  

Oh, and one last thought...what’s with all the apologies to the highly opinionated folks.  Certainly years of Kip 10 pain has given them a tougher skin than that.

PFDAN to all.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Lenny on Apr 14th, 2003, 9:50am
This past sept. i went a full week without using any trex :'( :'( :'( just to see if the # of attacks would reduce.
 Prior to doing this,i was getting 6-7 attacks per day.That week without the trex.,i avg. 3- attacks per day. Went back on the trex.,the first 2-days ( if i recall correctly ) i was getting 3- a day and then back to 6 a day.These were full blown clusters ( not what Bob described ) now dont get me wrong( I AM IN "LOVE" WITH TREX  :D ) as far as the word REBOUND goes,that is what my doc calls them and as i mentioned above claims that too much( trex) causes them ( i forgot what his def. is too much ) .  This is my personal exper. with this medication.
Could you guys please share with us your exper. with this med.
1- how long you have used it ?
2- how many attacks per day ( prior to using it ) ?
3- how many attacks per day ( while using it ) ?
4- did you inj.yourself each time ?
5- I sure hope none of you take this as a personal attack on you ( that is not my intention ) i just want to know your exp.with this.

I thank each of you in advance for your responce ( reg.your personal exp.using IMITREX INJ.) and will jump back on sometime in the afternoon ( at work ;D ;D )

                                  PFDAN  to all
p.s. Ueli - Please dont use those big words ( i wont be able to understand )  ??? ;D ???
Title: Re: Can Imitrex Cause Rebound HA's?
Post by cluster0557 on Apr 14th, 2003, 10:32am
Lenny,

Here is my summary

1) Have been on Imitrex for just over a year.

2) Normal Day 3-4 Clusters. Avg Cluster 2.5 hours While using Imitrex as below. Prior to Imitrex I used Maxalt at 5-6 attacks per day. Imitrex did not reduce attacks Verapamil did.

3) I Use Imitrex 2 days in row skip a day.

4) First Course Of abort is O2.

5) If I use Imitrex on 3rd day I will not get a pure Cluster series but instead I get a Migraine with clusters on top of the migraine sometime late that day. Happens 60% of the time. So on Day Three I use Nubain to kill pain. Don't get much done but no pain. ;D

6) My attacks are 7 am, 2pm 7pm and at 11pm. Almost can set a watch by them. (The 11 pm one is erratic)

7) If O2 a bust then is time for Imitrex. O2 will soothe the beast 30-40% of the time.

8) I Inject each time now. Can't deal with the pills or nasal stuff. Went to Vial and Insulin needle last week.

Hope this helps.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Bob P on Apr 14th, 2003, 10:38am
I have used injectable trex one night.

I usually get my 1 1/2 hour after falling asleep headache, jump up, take a tab of cafergot, jump on the O2.  In 15 minutes it's gone and I go back to sleep for the rest of the night.

The one night I used the trex I wound up getting up to inject 1/2 dose 3 times that night.  I felt horrible the next day so I never used it again.  Now since this was the first trex I'd ever taken, you can't really say the increased number of headaches that night was due to taking too much trex.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Lenny on Apr 15th, 2003, 9:32am
Bob,
From what i understand,you used it one time and had 3-seperate attacks after (inj.)yourself ( is this a normal thing for you - 4 per night? ).  Your normal routine  as far as aborting ( from what you stated above ) you would sleep the rest of the night. So in your opinion,were those cluster that you had or rebound ?
  On a side note, i took cafergot for about 3-months as a preventative ( 1-hour prior to bed ) worked great the first 2,then all of a sudden stopped working ( the only complain i had for that med., i had such a hard time waking up in the morning )
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Bob P on Apr 15th, 2003, 10:43am
Lenny,

That's what I was trying to say.  I had many more attacks the night I used Trex vs my old standby of cafergot.  I don't call the extra attacks rebound headaches.  I'm also not sure why I got them.  Maybe cafergot has a longer half life and keeps them away the rest of the night.  Maybe with no medication I would get 3 or 4 headaches a night (I don't know because I always take something with the first headache) and the shorter half life of Trex let them happen.

The thing is, rebound headaches are caused by the prolonged overuse of medications.  Since this was the first time I had used Trex it obviously couldn't be from overuse of it.  I think Trex just doesn't prevent the attacks for a long a period of time as other meds.  You used cafergot as a preventative.  I've always used it as an abortive but the long time it stays in my system gives me some preventative benifit also.
Title: What shall i cRe: Can Imitrex Cause Rebound HA's?
Post by Lenny on Apr 15th, 2003, 7:56pm
thank you cluster0557 and Bob,
 
 Thats where i got confused ( the word rebound ) i had no idea that that was a differant type of a headache, i honestly thought that the term ( rebound ) meant more frequant attacks. I will have to give my doc a piece of my mind for he is the one that calls them rebounds ( i guess to not confuse me ??? ). As far as Ueli saying that it stays in your system for 2  hours. "UELI" what is your theory on this : i have had on a number of occas. where i abort the beast ( imitrex inj. ) and 30-minutes later he is back full force ???
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Bob P on Apr 16th, 2003, 9:50am
I think what Ueli is referring to is that the elimination half-life of imitrex is 2.5 hours.  After a couple of hours the trex you injected is down to 1/2 of what it was.  Another 2 hours and it's down to 1/4, 2 hours and 1/8, etc.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by Bob P on Apr 18th, 2003, 5:07pm
1: Cephalalgia 1995 Jun;15(3):230-6

Published erratum appears in Cephalalgia 1995 Oct;15(5):446
Cluster headache attacks treated for up to three months with subcutaneous
sumatriptan (6 mg). Sumatriptan Cluster Headache Long-term Study Group.

Ekbom K, Krabbe A, Micieli G, Prusinski A, Cole JA, Pilgrim AJ, Noronha D

Department of Neurology, Soder Hospital, Stockholm, Sweden.

In the first three months of a 24-month open study to assess the safety and
efficacy of subcutaneous sumatriptan 6 mg in the long-term acute treatment of
cluster headache, 138 patients treated a maximum of two attacks daily each with
a single 6 mg injection. A total of 6353 attacks were treated. Adverse events,
reported in 28% of sumatriptan-treated attacks, were qualitatively similar to
those seen in migraine long-term trials. Their incidence did not increase with
frequent use of sumatriptan. There were no clinically significant treatment
effects on vital signs, ECG recordings or laboratory parameters. Headache relief
(a reduction from very severe, severe or moderate pain to mild or no pain) at 15
min was obtained for a median of 96% of attacks treated. There was no indication
of tachyphylaxis, decrease in the speed of response, or increased frequency of
attacks with long-term treatment. This study demonstrated that, in long-term
use, subcutaneous sumatriptan 6 mg is a well-tolerated and effective acute
treatment for cluster headache.
Title: Re: Can Imitrex Cause Rebound HA's?
Post by aowg on Apr 29th, 2003, 3:28pm
Although I have suffered CHs for 25 years, it's only been in the last couple of weeks that I found anything that actually worked at completely relieving the pain, although various narcotics have left me in such a state that my head still hurt, but hey, I didn't care that much. Now, the state of medical science has changed over all these years, of course, but things that had worked, like ergotrates, quit working. Mercifully, I had gone as long as 4 years between clusters, so a lack of effective pain relief only became really, really important just every few years...

Between my previous cluster (which was, I think, but don't recall for sure, 2 years ago) and the most recent one that's been going on about 3 weeks now, my wife had been diagnosed with migraines (the wimp  ;)) and our GP gave her a prescription for Imitrex tablets, 50mg. These seem to have worked well for her.

Mercifully, over the years, the intensity of my headaches seems to have declined; the clusters themselves are also shorter. But a week or so ago I had a real doozy, somewhere between a 7 and 8 and I was lapping the kitchen table and cursing. She said, take one of these, I don't think it can make it any worse and wow! Inside of 5 minutes, the pain was bearable, almost completely gone in 10 to 15 and totally gone in 20. My usual CH is 25 to 45 minutes with the ache in my skull subsided enough to allow me to go back to bed in anywhere from 2 to 4 hours. I used them 3 nights in a row with no ill effects, then went two nights without an HA and finally went to see the doc before I used up her entire prescription and he gave me a script for 100mg tablets.

The 100mg tablets work like a champ. I actually had one of my (rare for me) daytime headaches that kicked in while I was on the way to pick the prescription up just a about 2 hours ago. It mutated into an 8 by the time I got home, I popped the tablet, lapped the kitchen table for 5 minutes, dropped to a brisk walk in 8 or 10 minutes and it was completely gone in 20. Whoever invented this stuff, I salute you!

To make this long story longer, my observation is, I've personally had no rebound. I was never one much for experiencing rebound, regardless the treatment, so FWIW, given how fast and thorough the relief is, I'd certainly recommend giving it a shot.


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