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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Question about abortives
        
(Message started by: jadedgazer on Dec 15^th, 2003, 8:11am)

Title: Question about abortives
Post by jadedgazer on Dec 15^th, 2003, 8:11am

Does anyone have any idea about what kinds of legitimate abortives are out there that work other than the triptans? I cannot use any of the triptans, i.e. Imitrex, Zomig, DHE. They cause intense chest pain, my doctor took me off them for fear that they could cause me to have a heart attack.

As of right now the only abortive I have is Oxygen. It is really difficult to tote a tank everywhere I go. There has to be something else I can use when I am out and about; school, shopping trips (it is an hour and a half, one way, to the mall folks), etc.

Any ideas you have would be appreciated.

Title: Re: Question about abortives
Post by Prense on Dec 15^th, 2003, 8:25am

It's not working for me, but some have had some success with 4% lidocaine applied inside the nose with a dropper. It's in the archives somewhere...

Chris

Title: Re: Question about abortives
Post by pubgirl on Dec 15^th, 2003, 8:31am

Jackie

The only drugs recommended by the doctors here that I know of are 02, topical lidnocaine and ergotamine (which apparently is too slow anyway)

The other alternatives e.g.opiates and painkillers don't appear to work

Wendy

LIGNOCAINE
(from the same article I quoted on the General message board)

"Topical Lignocaine

Lignocaine solution 20-60mg given as nasal drops (four to six per cent Lidocaine solution) or a spray deep in the nostril on the painful side results in mild to moderate relief in most patients, although only a few obtain complete pain relief. Intranasal lignocaine therefore serves as a useful adjunct to other abortive treatments but is rarely adequate on its own"

Title: Re: Question about abortives
Post by Bob_Johnson on Dec 15^th, 2003, 9:03am

I've had 100% success with this one.
----------------------
1: 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: Question about abortives
Post by jmorgan52 on Dec 15^th, 2003, 9:04am

Sorry about the triptans affecting you badly, Jade but...

How many time did you try them? My first few experiences with the imigran injection was a quite scary. I felt my chest tighten, could feel my pulse beating hard and a strange sensation in the chest. I reckon a lot of the bad vibes I got were caused not so much bt the trex, but by my own fear of getting a heart attack. Are you sure it is really pain, or just the wierd sensation and the imagination running wild tha many of us get using trex? After several 100 injections over the years I know what to expect now and it always ends with relief.

You look very young if that's you picture in your post and seem an unlikely heart attack candidate. Maybe you should discuss this again with your perhaps "over cautious doc"?

Please don't take this attempt at advice the wrong way, but I have not come across any abortives in the last 35 or more years of CH that did anything for me. Imigran inj was the first and still is the only way for me to stop a CH in it's tracks.

My only complaint is that it is so expensive!

John

Title: Re: Question about abortives
Post by jadedgazer on Dec 16^th, 2003, 12:09am

Bob, thanks for the info...I will check that out.

John...You are toooo kind! I am in my mid-30's. But you are my new best-bud! :)

I have worked with Imitrex in various forms for about a year and a half. Also with Zomig. They have caused chest pain and pain in my arms that has increased to a level that is frightening over time. I also began to notice some heart palpitations. The doc's have told me that if the palps don't cease soon we are going to have to do a battery of tests to see if perm damage was done. Hopefully this isn't the case. At any rate, the triptans aren't an option anymore and neither is DHE IV as it would have a similar result for me.

Title: Re: Question about abortives
Post by ozzman on Dec 16^th, 2003, 11:34am

I get heart palpitations from the Verapamil, but it is usually temporary.

Also the chest pain has been attributed to esophageal (sp?) pain, not heart pain, though it could happen. Before it stopped working for me, I used to take Cafergot under the tongue (for fast absorption) When it used to work, 1/2 or even 1/4 of a pill would do the trick within 10-15 min.

Just some thoughts.

Ozzy

Title: Re: Question about abortives
Post by chronic_chic on Dec 16^th, 2003, 1:44pm

ozzman, you get heart palps from verap? that is unusual because it is an antiarrythmic...it's primary use is for high blood pressure and for heart arrythmias (palpitations)!

jackie, i can take some triptans and also DHE, but not imitrex by injection. it causes my heart to beat far too fast. i have tachycardia (my resting heart rate is over 90) and also occasional palpitations, and imitrex injections aggravate this condition greatly. DHE causes chest pains for me, and at times in the hospital they have held the DHE until my heart rate drops below 90, but they allow me to use it generally because they feel i will be ok. the cardiologist wouldn't give a consult when i was hospitalized because they felt that tachycardia is not a problem in a 22 year old. (that's good preventive medicine working for ya! don't 22 year olds turn 40 and 50 some day?)

my family doc ordered an echo and had me wear a halter monitor for 24 hours to check for major palpitations. however, the palps are so occasional that nothing major showed up. the echo was fine. yay :) so overall, i just have the heart rate of a small child! but it appears that my heart is healthy...so they let me keep using DHE...but the imitrex injections cause so much pain and rapid heart rate that it doesn't really seem very safe for me....just opinions from someone in a similar situation.

~Lizzie :)

Title: Re: Question about abortives
Post by ozzman on Dec 16^th, 2003, 4:08pm

Lizzie,

I have noticed that particularly after I up the dose of Verapamil, for the first few days 20-30 min later I have a certain "flutter", or I can actually feel my heart beating, after those few days, it is normalized. My completely non-scientific reasoning for this, is I guess the heart is trying to compensate for the decreased blood pressure and then it normalizes...but then I could be completely wrong...

Ozzy

Title: Re: Question about abortives
Post by jadedgazer on Dec 16^th, 2003, 4:12pm

Thanks Lizzie. This is something we have battled with various triptans, Imitrex, Zomig and even Maxalt. As I continued to use them the pain just increased and it would make my heart rate increase to a level that they felt was becoming a danger. I haven't tried DHE. We have discussed it though, since I am chronic. But my neuro wants to admit me for what he called an "extended stay" in the hospital, and right now that would be extremely difficult for my family as the hospital where I would be admitted is 4.5 hours from home. However, if we can't get a break in the pain soon or at least get it to a level that is tolerable, I will be considering a try at DHE even though it is scary. At this point they can shoot shark pee up my nose if it will help. LOL

It is hard for people who don't have trouble with some of these things to understand sometimes how bad the trouble with them can be. (If that makes any sense)

Title: Re: Question about abortives
Post by ozzman on Dec 17^th, 2003, 10:57am

Lizzie,

Like you say, it is unusual, but not impossible, one article I found:

Quote:

Near doubling of heart rate after intravenous verapamil for treatment of atrial fibrillation without preexcitation.

Orlov YS, Brodsky MA, Orlov MV, Allen B.

University of California Irvine Medical Center, Department of Medicine 92868-3298, USA.

Initial treatment of atrial fibrillation often involves pharmacological therapy to control ventricular response. While verapamil is usually safe and effective when used for this purpose, we report a proarrhythmic response. In this report a 30-year-old female presented with palpitations associated with atrial fibrillation and a ventricular response of 145 beats/min. Soon after she was given 5 mg of intravenous verapamil her ECG documented a regular wide QRS tachycardia at 290 beats/min. After 7 seconds the rhythm returned to an irregularly irregular narrow QRS tachycardia at 125-150 beats/min. At a later electrophysiology study there was neither evidence of preexcitation nor inducible supraventricular or ventricular tachycardia. These data suggest that verapamil may have been associated with acceleration of the heart rate. The mechanism of proarrhythmia may be related to an alteration in the atrial rhythm from atrial fibrillation to atrial flutter, with additional factors as well.

Publication Types:
Case Reports

PMID: 9392821 [PubMed - indexed for MEDLINE]

Ozzy

Title: Re: Question about abortives
Post by chronic_chic on Dec 17^th, 2003, 4:31pm

Ozzy,
have you spoken to your neurologist about this? because if you are having problems like that article describes, verapamil *might* not be the drug for you!
~lizz

Title: Re: Question about abortives
Post by mmaya613 on Dec 17^th, 2003, 8:41pm

I've only been using Trex injectors for a short time now. I think they are heaven sent. about 10-20 seconds after the injection, I get a prickly, tingly feeling around the back of my neck and shoulders. That's when the pain of the ch goes away immediately.

I haven't noticed an increase in heart rate, thank G-d.

My doc doubled my verapamil to 240mg per day:120 morning and 120 at night. After a prednisone taper of 6 days, Iwent pf for 5 days. Yesterday, I was shadowing big time. So, I took 240 mg of verap at about 5pm. I defenitely was anxious and feeling a bit hurried. But I slept through the night.

I think what I'm trying to say is that imitrex and verapamil are awesome. If your part of the crowd haviing difficulty using them ask the doc for alternatives, but I would risk it all to have relief from a kip 10 as I normally get without using abortives.

I hope you find what your looking for.

Best of Luck!

Mario ;;D

Title: Re: Question about abortives
Post by t_h_b on Dec 17^th, 2003, 11:58pm

Snorting lidociain 5% ointment has helped me reduce the intensity or abort CHs. It doesn't help everyone, but you should give it a good try with sufficient quantity and deep enough "snorting" so that you get a good burin going up in your nasal cavity.

Maybe you could get a smaller O2 tank to keep in the car.

Try some preventatives: Verapamil, melatonin, magnesium.

Good luck.

Title: Re: Question about abortives
Post by jadedgazer on Dec 18^th, 2003, 9:05am

Thanks for the input.

I take Magnesium already and have for a year. It does nothing to help my ha's. Simply takes care of any, ummm, how do I say this politely...well nevermind. I just know that it doesn't help with my ha's.

What about Amerge? Is it along the same lines as Imitrex and Zomig? If not, how fast acting is it? Could I use it when I am out and about, and still function normally...i.e. drive, etc.?

Title: Re: Question about abortives
Post by BlueMeanie on Dec 18^th, 2003, 10:56am

Amerge works for me guesstimating about 68% of the time. It doesn't take that long to take effect when it does work. About 15 minutes for me. As long as I take it before I get to a KIP 6. If I'm at a KIP 7 I use Imitrex injection instead.

Title: Re: Question about abortives
Post by jadedgazer on Dec 18^th, 2003, 11:06am

Bluemeanie,

Can you function when you take it...i.e. work, drive, take care of kids, etc? Of course, after the pain subsides.

Title: Re: Question about abortives
Post by BlueMeanie on Dec 18^th, 2003, 12:18pm

I feel no side effects at all. When it works, the CH just disappears and life is great.

Of course it doesn't always work. Then life SUCKS.

The bad part is if it doesn't work, you're screwed because you are not suppose to mix it with Imitrex.

Title: Re: Question about abortives
Post by chronic_chic on Dec 18^th, 2003, 1:01pm

has anyone taken frova?

~lizz

Title: Re: Question about abortives
Post by Marcel on Dec 18^th, 2003, 10:43pm

Last week my doctor gave me some samples of a new drug called Relpax and it has worked wonders for me. Its in tablet form and takes about 30 minutes to work but its much better than oxygen and Imitrex for me! Relpax is eletriptan HBr. Good luck!!

Title: Re: Question about abortives
Post by jadedgazer on Dec 19^th, 2003, 8:23am

Blue,

I can't use Imitrex anyway, so if it didn't work I would just be where I am now.