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Message started by futuremrstrotter on Nov 7th, 2008 at 11:44am

Title: Clusters & Pregnancy
Post by futuremrstrotter on Nov 7th, 2008 at 11:44am
Hello All!

       I have suffered with CHs for about 17 yrs. I am 34 years old and engaged to be married.  We do not have children but would like to have at least one.  My cycles usually come every 24 - 36 months and last for 2 or 3 months.  I wanted to know how any ladies out there have dealt with your condition while pregnant? Did your headaches stop? Have any considered not having children?  I am nervous about the possibility of becoming preg. in the future abd being hit with a cycle..


Title: Re: Clusters & Pregnancy
Post by Jeannie on Nov 7th, 2008 at 1:49pm
Hi !

Welcome!   I have two children.  Never  had a cycle while pregnant.   I think that there is at least one other mom on the boards that also doesn't get hit while expecting.  

Good luck!  Hope you stick around and tell us a little more about yourself!

Jeannie

Title: Re: Clusters & Pregnancy
Post by Bob_Johnson on Nov 7th, 2008 at 2:42pm
As I was preparing to post this group of reports I realized how old some of them were. A quick recheck on PubMed (the major source of medical materials) it was striking that there was nothing new on the subject. I cannot believe that people don't attend to this question and so can only assume that headache + pregnancy is not an issue of such significance that it gets much attention.
---------------



I checked drug info on medscape.com and Olanzapine is o.k. for limited use in pregnancy.  

Headache 2001 Sep;41(: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.
==============================
OTC meds are not very helpful with cluster, as you know, but may be one of the few options available to you. Some folks have good luck aborting/easing an attack by applying an ice pack to the pain site. Others find very hot water also works; others have used a hair dryer blasting the pain site works! No predicting; just try.
=============================

Re. special needs of women. Both of these in HEADACHE QUARTERLY, Vol X, #2, 1991: "Women and headaches:a comprehensive approach", p. 31-36.  "Special considerations in the management of headache in women", p. 37-43. The last one focuses on role of hormones in headache and how medications must be altered.
===============================
J Neurol Neurosurg Psychiatry. 2006 Jan 11  


Cluster headache in women - relation with menstruation, use of oral contraceptives, pregnancy and menopause.

van Vliet JA, Favier I, Helmerhorst FM, Haan J, Ferrari MD.

Medical Centre Haaglanden, Netherlands.

Abstract. In contrast to migraine, little is known about the relationship between cluster headache and menstrual cycle, oral contraceptives, pregnancy and menopause. We performed a population-based questionnaire study among 224 female cluster headache patients, and studied the possible effect of hormonal influences on cluster headache attacks. For control data, a similar but adjusted questionnaire was sent to healthy volunteers and migraine patients. We found that menstruation, use of oral contraceptives, pregnancy and menopause had a much smaller influence on cluster headache attacks than in migraine. Cluster headache can, however, have a large impact on individual women, for example to refrain from having children.

PMID: 16407458 [PubMed - as supplied by publisher]


Title: Re: Clusters & Pregnancy
Post by futuremrstrotter on Nov 7th, 2008 at 4:21pm

Jeannie wrote on Nov 7th, 2008 at 1:49pm:
Hi !

Welcome!   I have two children.  Never  had a cycle while pregnant.   I think that there is at least one other mom on the boards that also doesn't get hit while expecting.  

Good luck!  Hope you stick around and tell us a little more about yourself!

Jeannie


Thanks, this is good to know!  I have been a 'lurker" for some time but this my first post.  I live in Ohio and develop training materials for a call ctr company.  Thanks to this site, I finally got fed up with my then Internal Med. Dr and went to Cleveland Clinic to see a neurologist.  I had never realized that my headaches had a name and that there were others like me!  

Title: Re: Clusters & Pregnancy
Post by futuremrstrotter on Nov 7th, 2008 at 4:24pm

Bob Johnson wrote on Nov 7th, 2008 at 2:42pm:
As I was preparing to post this group of reports I realized how old some of them were. A quick recheck on PubMed (the major source of medical materials) it was striking that there was nothing new on the subject. I cannot believe that people don't attend to this question and so can only assume that headache + pregnancy is not an issue of such significance that it gets much attention.
---------------



I checked drug info on medscape.com and Olanzapine is o.k. for limited use in pregnancy.  

Headache 2001 Sep;41(: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.
==============================
OTC meds are not very helpful with cluster, as you know, but may be one of the few options available to you. Some folks have good luck aborting/easing an attack by applying an ice pack to the pain site. Others find very hot water also works; others have used a hair dryer blasting the pain site works! No predicting; just try.
=============================

Re. special needs of women. Both of these in HEADACHE QUARTERLY, Vol X, #2, 1991: "Women and headaches:a comprehensive approach", p. 31-36.  "Special considerations in the management of headache in women", p. 37-43. The last one focuses on role of hormones in headache and how medications must be altered.
===============================
J Neurol Neurosurg Psychiatry. 2006 Jan 11  


Cluster headache in women - relation with menstruation, use of oral contraceptives, pregnancy and menopause.

van Vliet JA, Favier I, Helmerhorst FM, Haan J, Ferrari MD.

Medical Centre Haaglanden, Netherlands.

Abstract. In contrast to migraine, little is known about the relationship between cluster headache and menstrual cycle, oral contraceptives, pregnancy and menopause. We performed a population-based questionnaire study among 224 female cluster headache patients, and studied the possible effect of hormonal influences on cluster headache attacks. For control data, a similar but adjusted questionnaire was sent to healthy volunteers and migraine patients. We found that menstruation, use of oral contraceptives, pregnancy and menopause had a much smaller influence on cluster headache attacks than in migraine. Cluster headache can, however, have a large impact on individual women, for example to refrain from having children.

PMID: 16407458 [PubMed - as supplied by publisher]


Thank you!  There seems to be so much that is not know about CH.  At least there's something for attacks during pregnancy, IF a cycle occurs.

Title: Re: Clusters & Pregnancy
Post by mezza on Nov 8th, 2008 at 7:00am
I have 2 children and had never gone into cycle while pregnant - with both of my kids -I went in cycle a year or 2 after having them

Title: Re: Clusters & Pregnancy
Post by Pixie-elf on Nov 8th, 2008 at 11:33pm
Stop tempting me to get pregnant just to keep the clusters away!

>_>;; I'm kidding of course. It would be interesting to see the statistics on this...

Title: Re: Clusters & Pregnancy
Post by DonnaH_again on Nov 9th, 2008 at 12:06am
I was an episodic sufferer, having headaches in spring and fall and lasting 3 months...for 28 years.

I never went into cycle while pregnant or nursing, but shortly after weaning, the cycles resumed.  I had a hysterectomy at age 48 and have not had a cluster headache since.


Title: Re: Clusters & Pregnancy
Post by ClusterChuck on Nov 9th, 2008 at 2:11am
I have never been pregnant (not from lack of trying!), so I can't answer you.

As soon as I become preggers, I will let you know if the clusters stop.

Chuck

Title: Re: Clusters & Pregnancy
Post by Pixie-elf on Nov 9th, 2008 at 5:58am

wrote on Nov 9th, 2008 at 12:06am:
 I had a hysterectomy at age 48 and have not had a cluster headache since.


Were you in cycle when you had the hysterectomy? Or did you take any hormones afterwards? Just curious, I hope I'm not asking too much. ^^;

Title: Re: Clusters & Pregnancy
Post by DonnaH_again on Nov 9th, 2008 at 9:20am
Good question!  I wasn't in cycle at the time and yes, I did take hormone replacement therapy for about 20 years after.  It has been three years since I quit.  It was just Premarin, not the combination of the two hormones.  My doc said the combo might cause me to have headaches.  Interesting.  I had forgotten about that.  

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