I finally went to my doctor yesterday because I was going down quickly in the last few days having 4 clusters a day and one that lasted 3 hours which is rare for me.  I am very sensitive to all medications so my doctor said he was at a loss of what to do after we discussed some options.  I copied and took info from this site and handed it to him and as I told him I didn't expect him to read it then, he noticed the small trial on Zyprexa.  He said he liked the idea and gave me samples of 5mg and 2.5 mg pills.  I came home and called my daughter (In her last year of Pharmacy School) and she said...do not take it, let me read about it first.  When she called back, she said she did find it indicated for clusters and that I only take it at the onset of one (as opposed to every day).  I got my chance at 8:45 last night!  I took the 2.5mg and by 9:00, I felt as if the inside of my head was shrinking and pressure was releasing...the viola, it was gone.  I mean gone!!!  I felt extremely mellow, somewhat dizzy, sleepy, with an airly feeling in the top of my head.  All shadows gone even now.  I am writing this 24 hours later and am still somewhat mellow and a little dizzy.  I slpet all night and had a 6 hour nap today which is very unusual for me (I was up for most of the 3 nights prior to this).  As my sister and I sad on the phone today, the next few days will be interesting because we know all too well to wait before we are thrilled with a new technique.  The only down side so far, for me, is the side effect lasting 24 hours.  Some people might not mind that at all, but I am very active and don't like to be slowed down.  My family thinks it was good for me, though.  Zyprexa is used to treat psychosis so we have had fun with that.  On a sad note....I can see where they would put people on something like that every day in hospitals/etc to keep them quiet!  I'll cut it in half next time and keep you all posted if you are interested. :)   

This is the abstract I first posted which got several of us "hooked" on it. I've used it since reading it and receive absolute relief with such speed that it's like flipping a light switch!

There have not been any follow-up studies of note since Rozen's report and so the standard lists of treatments rarely recognize it as an abortive--but I keep suggesting it here and some folks really like it.
===========

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.

PMID 11576207 PubMed

--------------------------------------------------------------------------------

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.

Bob has been reporting very, very good abortive results with this medication for quite awhile now.

Despite that, it doesn't appear to have gained general acceptance as a great abortive for most people around here.

I'm really happy with straight oxygen right now, but Olanzapine is on the top of my list if I need it. It's good to hear that it worked so well for you.

Keep us posted.

Marc 

Thanks for the replies!  Bob, that is the piece I copied and took to my doctor.  As I mentioned in a message, I am concerned with rebounds on this.  We'll see.

It's my second choice abortive following oxygen.

It happens to abort clean and quick which is not something one would expect from a pill.

for me it works as quick as a jab of trex without the icky feelings afterwords.

Good luck

WOW!

Hey Bob, how many Zyprexa mg do you take, and do you get the 24 hr slowing down side effect or any other after effects?

And E-Double, what kind of icky imitrex side effects have you experienced? (I haven't noticed imitrex side effects when I use it)

I use 5mg and have no side effects, no sedation, etc.

Bob Johnson wrote on Aug 29^th, 2009 at 8:41pm:

I use 5mg and have no side effects, no sedation, etc.

Wow. Cool. How about rebounds? Those pesky buggers seem to wanna keep popping up after abortives are used, so I suppose they're along for the ride with Zyprexa as well?

Bob-Glad you don't have the side effects (however they are nice and pleasant if you don't have to go anywhere).   :)  My sister never has side effects to anything and I am jealous, sometimes.  I have them to everything.

Bejeeber-As for the rebounds, I have always had trouble with that, too, with the abortives.  I thought it was because I was so sensitive to meds.  I learned to taper them REALLY SLOWLY breaking pills in halves, then fourths, etc.  It took me months to get off Prednisone one time due to rebounds, but I finally got it tapered enough, but not without a lot of complications from it that took a long time to get over.   :'(

I must share an interesting thing that I just figured out about my use with the Zyprexa.  You know how smart these clusters are and that they can tell time?   :)  I was just logging my headaches and noticed that since I have been taking the Zyprexa on Tuesday, I have had a headache exactly 33 hours apart!  That is opposed to the 3-4 hits a day I was having.  I thought maybe I had added wrong and had my husband check it...I was right.  So, my plan now it to take half of one at 32 hours and see if I can stretch the time out which I think might be the ticket.  I'll keep you posted.

Joni 

I've not had rebounds with Zyprexa and since there has been very little medical material on its use, no information flowing from those sources.

Interesting.....I am trying out a new Neuro tomorrow since I fired my last one 6 years ago......I hope this one listens to me..Getting hit hard and fast ....no sleep the last couple of weeks with an ER visit on Thursday as my O2 isn't doing the trick....I think I need a 25L....15L isn't cutting it right now....Since I hate the normal cluster meds as they extended my cycles before and gave me bad rebounds I just might ask him for an RX of this stuff....as a 2nd choice after my O2....I'll let you know how this one goes....Kinda nervous about a new Neuro...I hope he thinks outside the box!

Karen

Good luck at the doctor!   :)

Joni wrote on Aug 30^th, 2009 at 1:37am:

I must share an interesting thing that I just figured out about my use with the Zyprexa.  You know how smart these clusters are and that they can tell time?   :)  I was just logging my headaches and noticed that since I have been taking the Zyprexa on Tuesday, I have had a headache exactly 33 hours apart!  That is opposed to the 3-4 hits a day I was having.  I thought maybe I had added wrong and had my husband check it...I was right.  So, my plan now it to take half of one at 32 hours and see if I can stretch the time out which I think might be the ticket.  I'll keep you posted. Joni

Hows this working for you now Joni?

Lawrence-

Thanks for asking.  The Zyprexa is working out very well within 15-20 min (Can you believe it...a pill!) but I have had to learn the hard way how to do the dosing.  The 33 hours should have warned me, but I got so happy and when I would have a shadow, I would take 1/2 of the pill.  Well, I did that for a couple of the next HA's, then all of a sudden I had 3 HA's back to back with about 5-10 apart for a breather.  I looked at my Rx log and realized it was maybe rebound/withdrawal HA's.  Also, the half pill didn't work on a full blown cluster, though it did for the shadows.  To make this story short...It takes me 2.5mg for a cluster, then I should start tapering way before the 33 hours to avoid another HA.  That's where I am right now, at 21 hours after a pill.  To be continued...

Thanks
Joan   :-/

Joni wrote on Sep 4^th, 2009 at 6:07pm:

Lawrence- Thanks for asking.  The Zyprexa is working out very well within 15-20 min (Can you believe it...a pill!) but I have had to learn the hard way how to do the dosing.  The 33 hours should have warned me, but I got so happy and when I would have a shadow, I would take 1/2 of the pill.  Well, I did that for a couple of the next HA's, then all of a sudden I had 3 HA's back to back with about 5-10 apart for a breather.  I looked at my Rx log and realized it was maybe rebound/withdrawal HA's.  Also, the half pill didn't work on a full blown cluster, though it did for the shadows.  To make this story short...It takes me 2.5mg for a cluster, then I should start tapering way before the 33 hours to avoid another HA.  That's where I am right now, at 21 hours after a pill.  To be continued... Thanks Joan   :-/

hmm, interesting.

So its not good to use this pill for shadows. You know, shadows sometimes bother me more than the HA.

I see my neuro Tuesday, im gonna ask him about this pill, maybe getting me some sample bottles at least.
Thanks for this info Joni

Lawrence and Karen-

Di you go to the doctor?  What was the result?    :-?

Joni wrote on Sep 7^th, 2009 at 12:01am:

Lawrence and Karen- Di you go to the doctor?  What was the result?    :-?

I see my neuro tomorrow, i'm asking him for this Zyprexa.
Can it be taken with Verapamil?

I guess Karen has seen her doc already, but she hasn't chimed in... :(

Lawrence-Yes, my doctor has me on both Verapamil and Zyprexa.  Go for it.  Good luck!

Joni   :)

Saw my neuro today, I asked him about the Zyprexa, he wrote me a prescription for it, but was very hesitant.....he said this medication can have MANY SIDE EFFECTS, side effects which include AMNESIA, Delirium, Anti-social behavior, Paranoia, and also Parkinsons-like effects,... :o :o :o

dude frightened me a little to say the least.....i have the script but haven't gotten it filled yet, wanted to ask you guys who are taking it, HONESTLY, have you experienced any of these, or any UNWANTED side effects while taking it....

I have not tried it yet, but many people report a lack of problems.

Side effects tend to be different for different people, BUT that list generally pertains to higher doses taken by people who are taking it for other reasons.

Try very low doses and work your way up if you are concerned. What dose did your Doctor suggest to start with?

A list of side effects is a statement of POSSIBILITIES. It is not a PREDICTION of what will occur. Wisdom calls for knowing both the risk and asking the doc what to look for, i.e., symptoms of side effects.

The side effects that your doc reads in the medical literature are derived from studies of people who use it, often in significant doses, for days/weeks on end.

When we use for CH, it's one low dose, per attack, whereas, the patients on whom this drug was tested (for serious mental conditions), the dose will be about 4x larger. The point being, the risk of any side effect is nearly zip AND if you experience any impact, it won't hit you overnight. The relative slow onset will give you time to observe and talk to your doc.

Our experience here, for CH, has been one of effectiveness and safety--according to folks who have reported their experience. Only one person has reported some drowsy feelings but getting 100% relief.

As I keep writing, drug people say, in all seriousness, that if aspirin were up for approval today--it would fail! Side effects are too common. Yet we use it by the ton every day....

Knowledge and self-observation are how we protect ourselves with ANY medication--even the most benign OTC product.

(I hope that you gave your doc the abstract I posted at the top of this string giving the original report on using Zyprexa. He needs this information.)

Marc wrote on Sep 8^th, 2009 at 2:57pm:

I have not tried it yet, but many people report a lack of problems. Side effects tend to be different for different people, BUT that list generally pertains to higher doses taken by people who are taking it for other reasons. Try very low doses and work your way up if you are concerned. What dose did your Doctor suggest to start with?

My doc wrote the script for 5mg....to be taken as an abortive as needed, but no more than one 5mg pill in a 24 hour period

Bob Johnson wrote on Sep 8^th, 2009 at 3:00pm:

A list of side effects is a statement of POSSIBILITIES. It is not a PREDICTION of what will occur. Wisdom calls for knowing both the risk and asking the doc what to look for, i.e., symptoms of side effects. The side effects that your doc reads in the medical literature are derived from studies of people who use it, often in significant doses, for days/weeks on end. When we use for CH, it's one low dose, per attack, whereas, the patients on whom this drug was tested (for serious mental conditions), the dose will be about 4x larger. The point being, the risk of any side effect is nearly zip AND if you experience any impact, it won't hit you overnight. The relative slow onset will give you time to observe and talk to your doc. Our experience here, for CH, has been one of effectiveness and safety--according to folks who have reported their experience. Only one person has reported some drowsy feelings but getting 100% relief. As I keep writing, drug people say, in all seriousness, that if aspirin were up for approval today--it would fail! Side effects are too common. Yet we use it by the ton every day.... Knowledge and self-observation are how we protect ourselves with ANY medication--even the most benign OTC product. (I hope that you gave your doc the abstract I posted at the top of this string giving the original report on using Zyprexa. He needs this information.)

thanks Bob

Any one know whether Zyprexa plays nice with imitrex?

As in:

"Dang this Zyprexa isn't working, I'll just whip out my imitrex and get a quick jab then without fear of a bad interaction between these 2 drugs"

Or:

"I used my one allowable dose of Zyprexa 6 hours ago, so now that I'm being hit again, heck I'll just use my trusty  imitrex this time"?

Bob Johnson wrote on Sep 8^th, 2009 at 3:00pm:

(I hope that you gave your doc the abstract I posted at the top of this string giving the original report on using Zyprexa. He needs this information.)

I did! He has his own copy now. Thanks Bob, kudos to you :)

Hey guys....

Had a chance to try the Zyprexa......I had a hit coming on around 11 am....immediately took the Zyprexa....the hit started coming on kinda fast in its usual fashion...I took a 5mg pill.....the HA started diminishing after about 15-20 minutes.....it does abort clusters....it just takes awhile. I got drowsy afterwards, and also have a soreness in the back of my head.....the soreness is still there....hours later.

Hey guys.....I had another hit last nite......took 10 mg of Zyprexa, CH was gone in 10 minutes.

Don't sleep on this info! The Zyprexa is working! Its becoming my abortive along with the O2, and Imitrex.

bejeeber wrote on Sep 8^th, 2009 at 6:43pm:

Any one know whether Zyprexa plays nice with imitrex? As in: "Dang this Zyprexa isn't working, I'll just whip out my imitrex and get a quick jab then without fear of a bad interaction between these 2 drugs" Or: "I used my one allowable dose of Zyprexa 6 hours ago, so now that I'm being hit again, heck I'll just use my trusty  imitrex this time"?

hey bejeeber,
i just read in here that they play nice together ;)....7th page, 4th paragragh

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Ooh - that is certainly encouraging - my Zyprexa antennae are fully extended now!  ;D

bejeeber wrote on Sep 11^th, 2009 at 9:48pm:

Ooh - that is certainly encouraging - my Zyprexa antennae are fully extended now!  ;D

jeeb,
I got hit last nite with an oncoming CH.....took Zyprexa and also got on the oxygen.....i think i goof'ed up by doing that because that combo took the CH away within minutes...no longer than 7 minutes.....so I got off the oxygen
thinking that the Zyprexa in my system would keep it away once it was gone....the headache came back again 1 hour later......my analysis....i think the oxygen reduced the effectiveness of the Zyprexa. In so many words, the Zyprexa couldnt do anything because the oxygen aborted the HA. So it was as if I took Zyprexa being pain free. if you take Zyprexa when you're pain free it wont do anything, its only able to abort a hit after the hits already incoming.

Lawrence wrote on Sep 12^th, 2009 at 4:45pm:

............my analysis....i think the oxygen reduced the effectiveness of the Zyprexa. In so many words, the Zyprexa couldnt do anything because the oxygen aborted the HA. ......

To me, that seems like a huge leap to conclusion.

I would suggest waiting to see if that happens consistently before making a treatment decision for yourself.

Most of us cannot even begin to count the number of "cause and effect" things that we were sure of - but eventually found to be wrong assumptions over time.

Sometimes the hits just come again............

Marc


ETA:
I make these comments because I wouldn't want to see you (or anyone else) trash something that just might be a very good part of your success.

Marc wrote on Sep 12^th, 2009 at 7:24pm:

Sometimes the hits just come again............ Marc

Thats true. I'm confused by it, because I added the Zyprexa in the equation.....I don't know... :-/

Just stay with it, man!

Keep trying what feels right.

I'm an O2 freak (in case you hadn't noticed) but that doesn't mean that it is the answer for you. My point was to NOT give up on anything too soon.

MANY things we use to attack our condition are a process, not a one time event.

Marc

That result you got there last night is tuff to figure out for sure, not to mention disappointing, Lawrence. Dang.  :-/

HA coming back in an hour certainly is typical for me if I use O2 for a wake up hit - I can see how it seems like the Zyprexa didn't do it's thing.

Causes me to wonder about this whole simulataneous O2 and Zyprexa approach, and for that matter simultaneous O2 and imitrex. Hmmmm.... I'm gonna start a new topic about that!  :D

Hi All-

Glad to see the interest and some success with the Zyprexa.  I had no idea what I was starting!  It worked for me every time within 15-20 minutes without fail and seemed to keep me pain free for about 24-33 hours at 2.5 mg.  I cannot speak to the 02 issue because I don't have much experience there.  The only thing I can say is that you had 2 variables so there is no way you can know for sure what happened.  Good luck!

Tip...When I was finished with it, I tapered the Zyprexa for 4 days.  Took half of a pill for 2 days, then a fourth of a pill for 2 days.  I am always fearful of abrupt stops of medication during or near cycles.  I just finished it yesterday.  I'll keep you posted.

-Joni :D

thanks Joni.....


The beast showed up for breakfast this morning, and got SERVED.......

a tall can of whoop-ass.....

I felt that slight "twinge" feeling in the right side of my head this morning....letting me know the HOR (hound from hell) was on its way....i quickly popped in 10 mg of the Zyprexa.....Beast annihilated.............I could feel the HA trying to get stronger after I took it....letting me know it wasn't a "false alarm".....(u know sometimes when you feel that twinge the CH doesn't always come....)

the key, just like anything else....is to take a dose the moment you start to feel it....don't wait 8-)

Zyprexa is working well for me as an abortive :)

re. #36. Your experience reminded me of the only time that CH would lead to a SMILE! When the Zyprexa hit me the pain disappeared with such speed and completeness that it was like a light switch being thrown!

Oh, that it was so good for all CH folks....

Bob Johnson wrote on Sep 14^th, 2009 at 8:21am:

re. #36. Your experience reminded me of the only time that CH would lead to a SMILE! When the Zyprexa hit me the pain disappeared with such speed and completeness that it was like a light switch being thrown! Oh, that it was so good for all CH folks....

i'm ready to go back to work now