Hello cluster board,

I was recently prescribed imatrex, which has worked very well to abort my attacks. After i gobbled up all the samples my doc gave me, i just charged a very painful $175 for 6 more doses of the nasal spray, as my insurance doesn't cover drugs. What i'm realizing now though, this cluster is lasting particularly longer (2 mo instead of 1 mo). I'm not getting attacks everyday, but maybe  twice a week with intermittent shadows. Anyone experienced this with imatrex?

Oh, and I guess i should introduce myself. Bryan, from Brooklyn. hello anyone/everyone.

Oxygen is cheap.

         Potter

What other meds are you on by chance?  Anything as a preventive?  You should also check into the cost of O2 as an abortive .

There has been some talk about the use of Imitrex and some other meds extending the length of a cycle.  

Let us know what other meds you may be taking and consider looking at the O2 links to the left.  O2 is a safe and effective abortive for many many people.

Hi Bryan,

The more Imitrex I use, the more often and severely I get hit.   It's a vicious cycle.  

As the others have said, check out the 02 info on the left of your screen.  

If you get a chance, tell us a little more about yourself.  

Welcome to CH.com.

Jeannie

Your question prompted me to review the medical literature on this issue. Results: only one abstract, in addition to the one following, which reported an increase in attacks/duration. Both reports say that the person's pattern returned to pre-Imitrex levels when they stopped using it. Note this abstract is reporting six peoples' experience; the second report covered four patients. NOT broad based population studies....

Second: when folks give their experience with any med, always keep in mind that they are reporting a case of one--themselves. They may have strong opinions about the med, their experience, etc. but this is never a substitute for medical reports with well gathered and evaluated data. Just a cautionary note as you read!
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Headache. 2004 Jul;44(7):713-8.  Related Articles, Links  

 
Subcutaneous sumatriptan induces changes in frequency pattern in cluster headache patients.

Rossi P, Lorenzo GD, Formisano R, Buzzi MG.

Objectives.-To document the relationship between the use of subcutaneous (SQ) sumatriptan (sum) and a change in frequency pattern of cluster headache (CH) in six patients. To discuss the clinical and pathophysiological implications of this observation in the context of available literature. Background.-Treatment with SQ sum may cause an increase in attack frequency of CH but data from literature are scant and controversial. Methods.-Six CH sum-naive patients (three episodic and three chronic according to the International Headache Society (IHS) criteria) are described. Results.-All six patients had very fast relief from pain and accompanying symptoms from the drug but they developed an increase in attack frequency soon after using SQ sum. In all patients, the CH returned to its usual frequency within a few days after SQ sum was withdrawn or replaced with other drugs. Five patients were not taking any prophylactic treatment and SQ sum was the only drug prescribed to treat their headache.

CONCLUSIONS.-PHYSICIANS SHOULD RECOGNIZE THE POSSIBILITY THAT TREATMENT OF CH WITH SQ SUM MAY BE ASSOCIATED WITH AN INCREASED FREQUENCY OF HEADACHE ATTACKS.

PMID: 15209695 [PubMed]

I too used imitrex only in medicinally treating CHs... at first.  

It is too expensive and always relying on aborting the attack as opposed to preventing them was a losing battle.  It also isn't very good for you, and I found with overuse of imitrext I would actually increase the number of headaches I'd get due to "rebound" headaches caused by the imitrex use.  

I've found imitrex to be incredibly effective and functional as a tool used sparingly to abort bad attackes otherwise untreatable by other methods.  On the rare occasion that I know I absolutely can not risk being woken up during the night with a CH, and I have been getting them, and my other medications aren't working, I will take an imitrex pill before bed as a preventative, but this is very rare, and is not the intended use of the pill.  I assume it wouldn't work so well with the nasal spray.

A way to save money, increase effectiveness and potentially lessen the number of shadows and rebounds you experience would be to find alternate abortives (such as oxygen) and the addition of a true prventative medication (such as lithium, verapamil or prednisone).  Alternately you could consider the herbal or natural methods for aborting and preventing (such as melatonin, the water treatment, Kudzu root, etc.) in addition to your fall-back imitrex.  

Relying only on the Imitrex will get costly and lose effectiveness, and it's just not practical.  I'll try to use oxygen to abort before Imitrex any time I can, and use the Imitrex as a last resort.  I try to prevent attacks with Verapamil and Prednisone.  Talk these over with your doctor and see what he/she thinks.

Thanks to everyone for the response!

I've been looking into oxygen and some alternative preventatives, but for now these arn't practical because I've been traveling a lot for work. Trying to get through this cycle, but I'm definitely going to try out some other things when the next one comes around.

Man, what a website. Are there any support groups in NYC anyone knows about? I'd love to see what a bunch of cluster heads look like  together in person.

Everything above speaks os increasing the frequency of attacks but not of lengthening the cycle.

My guess would be that the length of the cycle wouldn't really change, short of a few rebound headaches.  However, I'm no doctor.

I see alot of reference to Oxygen by ch sufferers, i tried it once at an oxygen bar at the airport and only got an extreme headache. Maybe my timing was coincidental or something but i am afraid to rey it again? Has anyone heard of oxygen causing an occurrance?

whip wrote on Jun 23^rd, 2009 at 3:06pm:

I see alot of reference to Oxygen by ch sufferers, i tried it once at an oxygen bar at the airport and only got an extreme headache. Maybe my timing was coincidental or something but i am afraid to rey it again? Has anyone heard of oxygen causing an occurrance?

There was no way you were getting anywhere near the proper flow rate at an oxygen bar. You need to be inhaling it through a non-rebreather mask (100% pure O2 on intake) at between 15 and 25 liters per minute.

Woo hoo another NYer (unfortunately another CHer)

I'm out in long island but originally from queens and have relatives in Brooklyn...burrogh park and bayridge

Anywho.... shots work the best as far as trex goes....Oxygen is still Aces though as far as many of us go and will preach.

I keep jabs on me though I use O2 and if things are truly rough I will use zyprexa to abort which is safe with both.

Best to ya and drop a line if u need anything...Im not too far...40 tops

Eric