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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Injections, Injections,  Injections
        
(Message started by: greumreaper on Oct 9^th, 2005, 6:28pm)

Title: Injections, Injections, Injections
Post by greumreaper on Oct 9^th, 2005, 6:28pm

I have heard much talk about injections. Seemingly the Trex injex is where most of you seem to be. However I am allergic to the class of drugs which amerge, imitrex and others belong to. So this leaves me with a blank. I simply do not want to talk smack about imitrex, but I simply cannot have it. Are there other medications that work fast besides the tryptophans. Is the trex.-related compounds the first line Rx? Are steroids usually given IM or PO?

I had received Nubain and Phenergan IM and that seemed to work better than imitrex and related compounds did. (Suppose the drug allergy had something to do with that) ::)

However there is no one speaking about the Nubain and related compounds being injected per cluster headache, so am I in the minority of people which it seems to work? Mind you not that it was perfect, but took an edge off anyways(the nubain did). Please let me know. .

Title: Re: Injections, Injections, Injections
Post by E-Double on Oct 9^th, 2005, 7:33pm

Probably because of the side-effects....
If you are going to be taking a narcotic after each attack you risk not only rebound but habituation and then possibly addiction.

Most who do use narcotics for such pain will use Duragesic patch/fentanyl.

If you can't use TRIPTANS maybe read up on Zyprexa.

It has been as effective for me as imitrex and is half the price and has not had any nasty effects.

Title: Re: Injections, Injections, Injections
Post by Mr. Happy on Oct 9^th, 2005, 7:39pm

on 10/09/05 at 19:33:23, E-Double wrote:

If you can't use TRIPTANS maybe read up on Zyprexa.

You and Bob Johnson have been touting this stuff, and I sure don't want it to fall by the wayside as an alternative to triptans. Keep recruiting.
Oxygen, used _correctly_, has a pretty good following.

Beta testers needed.
RJ

Title: Re: Injections, Injections, Injections
Post by unsolved1 on Oct 9^th, 2005, 9:54pm

I sometimes give myself IM shots of Stadol for 'heavy shadows', but for a full blown cluster attack, narcotics have been useless (for me). I also tried Nubain ... it was given to me at the Diamond Clinic and it was useless too. They gave it to me IV and I had problems breathing afterwards :-/

UNsolved

Title: Re: Injections, Injections, Injections
Post by Gator on Oct 9^th, 2005, 10:04pm

Mr.Happy is right. 100% oxygen is less expensive, more effective and has fewer side effects than almost any med used to treat CH. If you haven't tried oxygen, try it. Hell, demand a script for it from your doc. It is effective for somewhere between 50% and 75% of CH sufferers. when used properly.

Here is a link that tells about it's use and justifies high flow rates in CH treatment by Dr. Todd Rozen. Print this and take it to your doc:

http://www.chhelp.org/mhni.html

O2 is my first line of defense. I use 15lpm via a non-rebreather mask for 10 - 20 minutes. Knocks out about 75% of my attacks. Of course, trex injections is my second line of defense. I'm sorry you can't do the triptans. Do what E-Double suggests and talk to your doc about Zyprexa. If (s)he's okay with it ask him/her for a few samples. If it's gonna work, you'll know it after a couple tries.

There are some alternatives being talked about in other threads, ie Kudzu, LSA and psilocybin that people are using with varying degrees of success.

Steroids are usually prescribed PO with another preventative med such as Verapamil. Prednisone is normally started at a high dose like 60 - 80 mg per day and tapered off to nothing over the course of a couple weeks. This kills the attacks for a lot of people and lets them live a "normal" life until the prevent kicks in.

While you are printing and reading stuff and if you haven't done so, yet, print and read this:

http://www.brightok.net/~mnjday/chtherapy.pdf

It tells about various Preventative, Abortive, Transitional and surgical treatments.

Good luck!

Edited to add PO (po= per os = by mouth) to the steroids paragraph.

Title: Re: Injections, Injections, Injections
Post by Bob_Johnson on Oct 10^th, 2005, 10:38am

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: Injections, Injections, Injections
Post by Origin on Oct 11^th, 2005, 9:14am

on 10/09/05 at 19:33:23, E-Double wrote:

You're right about watching for rebound. The reason that habituation can be a problem (which happened to my cousin) is that his clusters would last 1-2 hours, but the pain med would last 4-6 hours. Duragesic is a great med, but same problem - in your system too long when you're not in pain.

I wish there was more good news on this front for us for today, but there are a lot more VSAO (very short-acting opioids) that might help in the future. When I can't break one and it become unbearable, fentanyl transmucosal (Actiq) has been very successful for me. But like you said, I've got to watch it like a hawk and set hard limits on its use up front so that it can't get out of hand. By doing that, I've had some good success.

Of course, I seem to also be one of the few who botox has helped immensely in reducing the amount of pain.