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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> new here--med question
        
(Message started by: calixte on Nov 13^th, 2003, 11:24pm)

Title: new here--med question
Post by calixte on Nov 13^th, 2003, 11:24pm

hi--

i've been suffering from episodic cluster headaches for 11 years. i've tried verapimil, inderal, propanolol, and they all worked for a while, and then stopped. my problem is that now i'm tryiing to work with two different doctors to find a preventative that works--one is my old doctor, and the other is a doctor that i have been assigned through the university's health service...one doctor is prescribing pamerol (or nortyptyline (sp?)), the other is prescribing something called atacan. have any of you tried either of these drugs? do you have any information on which works better? i can't afford imitrex, so i'm basically screwed to endure this cycle unless i find a preventative that works. thank you all for your help....

calixte

Title: Re: new here--med question
Post by BobG on Nov 13^th, 2003, 11:56pm

Welcome to the board.

About your verapamil….how high a dose? Some folks use upwards of 800mg before getting relief.

Pamelor (Nortriptyline) is a tricyclic antidepressant. It affects chemicals in the brain that may become unbalanced and cause depression.
http://my.webmd.com/content/drugs/3/4046_1209?bn=Pamelor

Atacand (Candesartan) Candesartan is in a class of drugs called angiotensin II receptor antagonists. Candesartan prevents the constriction (narrowing) of blood vessels (veins and arteries). It is also used to treat high blood pressure (hypertension).
http://my.webmd.com/content/drugs/1/4046_1452?bn=Atacand

I have used neither of those drugs but the latter looks, to me, as a better candidate for clusters than the former. But, I’m not a doctor and it would be unwise to follow my advice. Some body here should be able to give better advice than I can.

Title: Re: new here--med question
Post by calixte on Nov 14^th, 2003, 9:37am

hi bobg--

thanks for the reply and thank you for my welcome to the board. i'm really glad i found this place. i've never met anyone else that suffers from CH. when i talk about my headaches, people automatically think migraine and start asking me about food triggers.

i took verapamil for my headaches around 4 years ago, so i can't remember what the dosage was. it worked really well for around 2 years, and then it just stopped. it was the first thing that ever worked as a preventative for my headaches. when it stopped working, the doctor just took me off of it instead of increasing my dosage. does your body become immune to medicine after awhile?

i guess i'll try the atacan, then. yesterday was my second day taking it (the first day, i didn't have an attack, but yesterday, unfortunately, i did--i don't know if it's because the medicine needs time to begin working or because i went to a bar earlier in the evening--but i didn't drink anything but water!). i'm also trying melatonin (9mg per night, and last night was my third night taking it). i'm knocking on every wood surface i see in hope that something will work today, and that i'll be spared an attack. things don't look well, though. it's 9:30, i'm up, and the right side of my head is already tight and feeling a little bit of pressure. we'll see...

--calixte

Title: Re: new here--med question
Post by floridian on Nov 14^th, 2003, 10:27am

First question - do both doctors know what the other is doing? I'm assuming they do, and there is coordination.

At first glance, angiotensin antagonists and ACE inhibitors might actually make the headaches worse by allowing blood vessels to expand and press on the nerves... but given the complexities of everything affecting everything else, there is no way of telling that this is the case. A chemical that we label an angiotensin antagonist might be doing a hundred different things, and might be beneficial in spite of what we call it. What was your doctor's rationale for using the atacand? Haven't seen much written on CH and angiotensin. But lots written on expanding blood vessels causing pain.

Title: Re: new here--med question
Post by Cooked Brain on Nov 14^th, 2003, 10:59am

[smiley=hiya.gif] C and welcome!

on 11/14/03 at 10:27:00, floridian wrote:

First question - do both doctors know what the other is doing? I'm assuming they do, and there is coordination.

cause if there is no coordination:
[smiley=argue.gif]

Title: Re: new here--med question
Post by LSUnut on Nov 14^th, 2003, 12:15pm

You mentioned that you have taken verapimil, propranolol, etc. and they all worked for a while but then stopped. Your doc may be trying atacand just as another anti-hypertensive agent that works in a different way, which is understandable. I'm not sure about the use of pamelor, however. It has been used to treat migraines in the past , but some of its other effects in your case may be questionable. Pamelor has been reported to inhibit the activity of 5-hydroxytryptamine (serotonin). It is also known to decrease the pressor (stimulatory) activity of dopamine, norepinephrine, epinephrine, etc., which can lead to another small decrease in blood pressure. Some of the anti-depressants that have been mentioned here and used with some success are the SSRI's like prozac. This makes some therapeutic sense, since they block the uptake and increase the levels of available serotonin. The common abortives like imitrex and zomig are all serotonin receptor agonist. This is just FYI, and please do make sure your docs know what the other is doing. Also, some of the new H2 receptor blockers used as antacids (especially tagament) are known to significantly increase the plasma levels of pamelor. ;)

Title: Re: new here--med question
Post by calixte on Nov 15^th, 2003, 3:41pm

hi all--

thanks again for your replies. i have another appointment with a different neurologist on monday, so we'll see what happens. right now, i'm back to taking the nortriptyline (50mg). i hope someone gives me something that works sometime soon.

--calixte

Title: Re: new here--med question
Post by Lori on Nov 16^th, 2003, 12:30am

Welcome and hope you have an easy cycle this time around. Just don't give up because there are so many different meds out there to try. Just be sure you have abortives avail. Ask for samples! These docs have samples. Don't be shy. Also check out the Oxygen button here on the left. Not sure if you've tried this route,,but it is successful for many. Just read the info carefully and print up and take with you to the doctors. There is even a doctor info link there too so you can print info for the doctor. Also check out the OUCH button on the left..when you get to that site, in the toolbar click on Cluster Help and then click on Medications. Print that up too and read.
Let us know how you are doing.