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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> Triptan as preventative.
        
(Message started by: Bob P on Nov 23^rd, 2004, 5:32pm)

Title: Triptan as preventative.
Post by Bob P on Nov 23^rd, 2004, 5:32pm

Cephalalgia
Volume 24 Issue 12 Page 1045 - December 2004
doi:10.1111/j.1468-2982.2004.00734.x

Frovatriptan for the treatment of cluster headaches
HC Siow1, P Pozo-Rosich1 & SD Silberstein1

Cluster headaches both episodic and chronic are some of the most challenging headaches to treat. Although effective treatments are now available, some patients continue to be unresponsive to standard therapy. We present 17 patients from our practice whom we treated preventively with frovatriptan, a new triptan with a long half-life. The promising results suggest that this medication may be an useful addition to our ammaterium against this painful disorder.

Title: Re: Triptan as preventative.
Post by pubgirl on Nov 23^rd, 2004, 6:43pm

Are they saying it stopped the attacks in these patients? I'm not sure what "promising" means [smiley=huh.gif]

Trouble is, not many here seem to have had great results with Frova, some even said it gave them a migraine type headache in addition to the CH hits.

I'm a bit loathe to go down the triptan prevention route as apart from no-one I know who has tried it thinks it works, I also would have thought you are then in trouble if you get hit and have no 02 as you can't take more than your two triptan doses every 24 hours (or is Frova different in some way?)

Wendy

Title: Re: Triptan as preventative.
Post by Bob P on Nov 24^th, 2004, 9:39am

Unfortunately I don't have a subscription to Cephalgia so I can only see the abstracts of the articles and not all the details.

Frova does have a half-life of 22-23 hours so it stays in your system much longer than Imitrex (2-3 hour half-life). I read the testing on Frova and it said that doses up to 10 times what is receommended had little to no side effects. Theory is that if aborts your attacks, take 1 pill a day as a preventative.

Title: Re: Triptan as preventative.
Post by Giuliano on Nov 25^th, 2004, 6:50am

Hy guys,

We even heard about a new triptan formula with this features coming during last our italian meeting in may.I was getting by doctor 2 pills to test based on feat. and did test them with no result neither as preventive nor abortive ......but it could not be the same ,since I'm italy.
Keep us in the loop about it.

Is anyone doing or did some trials with SSRI medicine as preventive ?

Thanks
Giuliano

Title: Re: Triptan as preventative.
Post by vig on Nov 25^th, 2004, 12:12pm

Zomig has a longer half life too.

Title: Re: Triptan as preventative.
Post by Roxy on Nov 29^th, 2004, 7:56pm

Since the Relpax quit working for me, I am trying Frova. I've only been on it for about three weeks now, but I am using it as a preventative. I take one table around noon, and another around 9pm. I got the migraine type headaches for only about three or four days....then my body seemed to adjust.

It has been working. I get a few breakthroughs, probably only two or three a day, and they seem to only hit around 8 on the kip scale, and don't seem to last longer than 30 or 40 minutes. I know that nothing I have ever tried has kicked all of my ch's away, but this treatment might really do the trick for a lot of people.

I just hope this one keeps working longer than the Relpax did.

Title: Re: Triptan as preventative.
Post by JJA on Nov 30^th, 2004, 8:46am

on 11/23/04 at 18:43:37, pubgirl wrote:

Are they saying it stopped the attacks in these patients? I'm not sure what "promising" means

Quote:

In the group of 9 patients with episodic cluster headaches, 8 of them had a good response with 100% relief with no cluster headaches while on frovatriptan... One patient...had a moderate response with 50% improvement in their headaches. This patient was newly diagnosed, probably chronic and was in the 10th month of his cluster cycle...

Of the 8 patients with chronic cluster headaches, 3 had complete relief, 1 patient had at least a 75% response rate, 2 patients had 50% relief and 2 patients had no relief. Of these 7 patients [You do the math, I count 8???] 1 took 5mg q day, 6 took 2.5 mg bid and 1 took 2.5 mg q day.

Jesse

Edited to add: This is an uncontrolled (no placebo group) study. Patients were allowed to be on other medications at the same time, but not other triptans. Most were taking verapamil and melatonin while the effectiveness of frovatriptan was being assessed.

Title: Re: Triptan as preventative.
Post by Bob P on Nov 30^th, 2004, 10:04am

Quote:

Zomig has a longer half life too.

The mean elimination half-life of zolmitriptan and of the active N-desmethyl metabolite is 3 hours.

Title: Re: Triptan as preventative.
Post by unsolved1 on Nov 30^th, 2004, 10:21am

This is all great. Too bad that Frova won't help me. I tried it several times at MHNI and suffered the consequences.

Thank god for Imitrex !!

Unsolved

Title: Re: Triptan as preventative.
Post by pubgirl on Nov 30^th, 2004, 1:15pm

I tried Zomig before going to bed as a prevent when in cycle as an experiment as I still had 02 as my back-up if it didn't work.

It didn't

Got hit an hour later as usual

Wendy

Title: Re: Triptan as preventative.
Post by Gator on Dec 2^nd, 2004, 2:04pm

I've seen different people on here saying Zomig kept them pf for anywhere from 10 to 24 hours, depending on the person. For me, I could use it and get hit an hour and a half later.

As with everything else...it may help some. I am happy for those people.

Gator

Title: Re: Triptan as preventative.
Post by Lizzie2 on Dec 2^nd, 2004, 11:32pm

Yay it finally got published. My former neuro did that study. I've been saying for quite a long time that there were studies done on triptans as preventives, but nobody ever believes me! The intention in this article is prevention for a very short term....generally not meant to be used for chronic cluster headache.

The authors (while I definately wouldn't speak for them) all practice under the premise that any analgesic (including triptans) cause rebound. I can't get my current neuro to let me take Amerge preventitavely at night, which is the only triptan which has worked for me so far.

Ah well...I'll look for the full article if you all want.

Lizzie2/Carrie