this week i went to a pharmacy and bought tablets of dihydroergotamine even if neuros havent approved it as they tell me that it is too old medicine to use these days.my first choice was supposed to be ergotamine but it isnt manufactured in form pill from mouth so ended up in the second choice.the pharmacist told me that the only difference between dihydroergotamine and  ergotamine is that the first one hasnt got caffeine in its ingredients so i should take along a panadol extra or drink two cups cups of coffee.i tried it three times in the beginning of crisis.took the dihyergotamine pill along with 2 cups of coffee but didnt see much of a relief.
so has anybody used this?did u see any relief?
i read somewhere here that ergotamine must not be mixed with imitrex but is there any other painkiller/abortive medicine(i call them all painkillers)that can be combined with for better results?
any advise about all these would be deeply aprecciated

The problem with ANY oral medication is it takes too long for the body to absorb it and get it into your system. By the time it hits your system, the heacdache is firmly established and kicking your butt!!

I use cafergot pills, but I use them in combination with oxygen. When an attack starts I pop a cafergot and fire up the oxygen. The 02 beats it down, the cafergot buys me up to 12 hours of relief.

You'll find pain meds aren't effective for CH, the best course of action is to attack the mechanism of the headache. Whether it's an imitrex injection, (my last resort), or breathing pure oxygen, (my first resort and still the most effective for me), you need something that acts fast.

 If you don't have oxygen yet, you need to give it a shot. I can abort an attack in as little as 6 minutes. It's cheap and is having a high percentage of success.

Joe

DHE is a VERY powerful vasoconstrictor. It should NOT be used within 24 hours of using any other vasoconstrictor, including the triptan family of drugs.

I've had it administered IV in the hospital every 8 hours for three days. Extremely effective. I've also used it in nasal spray form (called Migranal), and while it was effective for the most part, it sure stuffed up my head for hours afterward.

Can you put a blank line between your paragraphs, please?

black wrote on Feb 17^th, 2009 at 3:09pm:

............ is there any other painkiller/abortive medicine(i call them all painkillers)that can be combined with for better results?

Yes, oxygen.

  Unfortunately o2 doesn't help me at all.i used it many times on 15 plm with the mask and still couldn't get any relief.
 But i am willing to give a try at this migranal.
Do u know if that is the same brand name in Europe also?

thanks for helping :)

DHE come in injection form;  A box of five ampules which you put into an insulin syringe and  then give yourself.  At first when I used it, the DHE alone would abort a CH, but eventually that stopped working and I have to use O2 in conjunction.  When I abort a CH with DHE and O2 I am usually free from the beast for at least 24 hours.  You must never use DHE in conjunction with imitrex or any other triptan or it will kill you.

In the US, it comes in nasal spray form as well. When I last used it, the user was required to break open a glass ampule which was then inserted into a nasal spray nebulizer. I know others on this board have used the IM injectable form as well.

If it is available in nasal spray form in Europe, I don't know what it's called.

Also, just to briefly address clavers' claim that "You must never use DHE in conjunction with imitrex or any other triptan or it will kill you," not necessarily the case. It has the potential to kill you, especially if you have coronary artery disease, but it's not a sure thing. I have mixed triptans under the close supervision of a doctor, and I'm still here writing about it.

Brew wrote on Feb 17^th, 2009 at 7:08pm:

DHE is a VERY powerful vasoconstrictor. It should NOT be used within 24 hours of using any other vasoconstrictor, including the triptan family of drugs. I've had it administered IV in the hospital every 8 hours for three days. Extremely effective. I've also used it in nasal spray form (called Migranal), and while it was effective for the most part, it sure stuffed up my head for hours afterward. Can you put a blank line between your paragraphs, please?

I have used DHE as an IM  injection for years and my MD JUST told me that it is available as a nasal spray!!!!!!!!
I found that it worked very well to abort my CH's.

Brew, I mentioned the treatment regime you went through to him, but he seemed stumped. Do you have any info/literature to support it that I could bring with me to my next appointment?

TIA

TIA - I have nothing in writing that outlines the procedure. It's 1mg DHE administered IV every 8 hours for a total of 9 doses. They strapped a telemetric heart monitor on me to cover their backsides, and I got relief from the first dose. Three days of boredom ensued.

Maybe have your doc call a headache specialist / neurologist to inquire about it. He/she can call my neurologist if they want. Just let me know and I'll PM his number.

Ergot based drugs should definatly not be used with any triptain.

I used to use a very similar drug over 20 years ago; whilst it did occasionally help notch down the pain it gave me 'spiders' turned the pain into a nueropathic pain beastie that burrowed in ad out of my skin.  :o Ended up in A&E with a nice doc who used local anthesthetic to numb the whole thing. Read the possible side effects, hopefully they will not happen.

The oral drugs are rarely absorbed for when you need it but might help if you are unlucky and get more than one hit a day; I find the O2 works for the early wake up call and 10am special so I tend to save maxalt [until I do get the imigran jabs!] for the mid afternoon one as by the late evening I am on the floor from tiredness and pain spike bruised feelings and starting to crumble and for me that helps.

The O2 is definatly worth trying and combeined with drugs for those b.a. days.
Do keep talking with your doctor and pharmacist so you can make the best informed choice for you.
Hope you find something that works for you soon.

I've been through similar experiences as Brew.  DHE in any form is a Powerful Vasoconstrictor.  It raises my BP through the roof.  I've used the nasal spray and the injectible.  You should be monitored for BP the first few times to be safe.

Ray

is it ok to take a DHE pill along with an energy drink at the first sign of a possible crisis??Or is this combination too much??

black wrote on Feb 28^th, 2009 at 8:07am:

is it ok to take a DHE pill along with an energy drink at the first sign of a possible crisis??Or is this combination too much??

I'll give you the diplomatic answer: It depends. Depends on what shape your heart is in. If you have no history of congestive heart failure or other heart disease, I'd say it's probably fine. But adding a high dose of caffeine to DHE if your heart isn't good - probably a bad idea.

I would do it under the supervision of my doctor if I were you.

thanks Brew!
 My heart is fine and i drink fast an(or two) instant coffees along with DHE pill without any problem but i havent got much experience with energy drinks.To tell the truth i have no idea one energy drink and how many instant coffees makes the same value.
I ve found here a cheap brand energy drink and bought some bottles
just in case.Last night got a hit,took the pill but i hesitated in slaming down the energy drink so i preffered again just plain coffee.i dont know if it was just heavy shadow or the pill did something with the coffee but i skipped a crisis anyway

the only bad thing is that i finally manage to get some sleep about 6 o'clock in the morning :D

Well, there's your problem right there - instant coffee. Bleeeeecchhhh!

Seriously, one serving of an energy drink (8 oz.)has about the same caffeine as a strong cup of coffee. Maybe a little more. But combining it with the taurine gives it a sort of "turbo" effect. If your heart is good, you shouldn't have a problem. But do let your doctor know you're doing it.

and without any cream or sugar it is just instant bliss[smiley=bag.gif]

[smiley=dankk2.gif]

Brew wrote on Feb 27^th, 2009 at 12:28pm:

TIA - I have nothing in writing that outlines the procedure. It's 1mg DHE administered IV every 8 hours for a total of 9 doses. They strapped a telemetric heart monitor on me to cover their backsides, and I got relief from the first dose. Three days of boredom ensued. Maybe have your doc call a headache specialist / neurologist to inquire about it. He/she can call my neurologist if they want. Just let me know and I'll PM his number.

Thanks much. Are you in Canada by any chance?

kika wrote on Mar 11^th, 2009 at 11:25am:

Brew wrote on Feb 27th, 2009 at 12:28pm: TIA - I have nothing in writing that outlines the procedure. It's 1mg DHE administered IV every 8 hours for a total of 9 doses. They strapped a telemetric heart monitor on me to cover their backsides, and I got relief from the first dose. Three days of boredom ensued. Maybe have your doc call a headache specialist / neurologist to inquire about it. He/she can call my neurologist if they want. Just let me know and I'll PM his number. Thanks much. Are you in Canada by any chance?

No.

Milwaukee, Wisconsin, USA.

I know this topic is over one month old but I thought it would be good to tell about my experiences with DHE ;-)

First of all, this "it's too old" argument is kinda pathetic (as if people don't use medicines which are almost 100 yo). DHE was the first medicine I tried and for some time it was really helpful. I was using it as a preventative (tho I heard some people use it as abortive)... The bad side is that you can't use other meds like Imigran, Cafergot etc. Also I was using liquid DHE and it was not very comfortable to use. Of course I've tried pills as well but those were giving me some strange side effects (I felt really weak, like with low blood pressure, even tho DHE lift your bp up). All-in-all, it's really worth trying :)

My experience with DHE was great.

I've been in cycle for 10 months now, and have not slept well for a good long while. I've had no break from the hits... Until the DHE.

I finally was able to enjoy life for a while, get some good quality sleep, have some pain free time. I was only on 0.25ml of the DHE, as I tend to have a lot of allergic reactions. But even that was enough to help me.

I'm on PRN usage of it now. When I need to sleep for a doctor's appointment, or something important, I use it. I'm going to see about getting a higher dose prescribed by my headache specialist in hopes we'll be able to break my cycle with a higher dose.

I tried it sub-q, and IM. Sub-q seemed to hit me faster, but I felt like the IM kept the hits away longer. So I'm using it IM for now.

If you don't have any problems preventing you from using this medication, I highly reccomend it. It was a blessing for me.


washed-out wrote on Mar 28^th, 2009 at 7:13pm:

I know this topic is over one month old but I thought it would be good to tell about my experiences with DHE ;-) First of all, this "it's too old" argument is kinda pathetic (as if people don't use medicines which are almost 100 yo). DHE was the first medicine I tried and for some time it was really helpful. I was using it as a preventative (tho I heard some people use it as abortive)... The bad side is that you can't use other meds like Imigran, Cafergot etc. Also I was using liquid DHE and it was not very comfortable to use. Of course I've tried pills as well but those were giving me some strange side effects (I felt really weak, like with low blood pressure, even tho DHE lift your bp up). All-in-all, it's really worth trying :)

That wasn't engrishy at all.  ;) Thanks for posting, it reminded me that I should post here too. It being an old medicine just means that it's had more experience.

PFDAN
Mystina

i think it's really worth too.
i ve been taking it for about a month now along with lots of energy drinks.One table every 8 hours (not always) and one or two energy drinks at the side of heavy shadow or beginning of ch.I am also taking
the vitamin D lately and all this time it hasn't passed kip 4 except once i had a 6.
I dont know if its just low cycle or all these help but it feels nice anyway.The bad thing is i am still on guard all the time no matter.
I know it's gonna come back again sometime soon in its hell form but
hope DHE still will stand the test.
By the way i am happy its cheap too.Here 30 tablets of 2.5 mg DHE cost 3 euros.Imigran nasal spray 15 euros and imigran injection 48!euros.Hope i dont need imigran again
my last thought is that later i ll grow up to be dissapointed?! :-[