This may help, particularly for anyone who has regularly timed attacks and is desperate for some sleep. In August 2008 I started taking 50mgs Sumatriptan tablets before going to bed. I reasoned that as I was definitely going to have an attack an hour or so after falling asleep and would need an Imigran (Imitrex) injection I may as well take a tablet before going to sleep as it takes 40 minutes to become effective and by the time the attack started I might get protection. This was successful on all but two nights. In early June of this year I decided to take another tablet at 7.30.a.m. every morning as I always have an attack at around 8.30.a.m. This was 100% successful. I have on a couple of occasions not taken a pill (deliberately) and got hit both times. There has been one trial over here in the UK on taking Sumatriptan pills as a prophylactic (preventative), however the trial was not timed in relation to the attacks, just one 100 mgs tablet taken three times a day, not a very efficient method of taking them as with a half life of 4 hours this only gives a maximum of 12 hours of protection a day if your lucky! The one certainty for many sufferers is that we are able foresee our attacks. It does seem to me that as the active ingredients in Sumatriptan tablets and Imigran injections are identical, in theory my use of Sumatriptan pills should work and also keeps my Doctor happy ‘cos they cost a lot less. I have been virtually attack free for the first time in 20 years of being chronic other than the odd mild attack at 8.45. in the evening. which I clear with a high energy drink. It also seems that unlike Frovatriptan its effectiveness doesn't diminish.
Regards
Mike
OUCH UK Trustee

Mike_P wrote on Sep 29^th, 2009 at 12:56pm:

This may help, particularly for anyone who has regularly timed attacks and is desperate for some sleep. In August 2008 I started taking 50mgs Sumatriptan tablets before going to bed. I reasoned that as I was definitely going to have an attack an hour or so after falling asleep and would need an Imigran (Imitrex) injection I may as well take a tablet before going to sleep as it takes 40 minutes to become effective and by the time the attack started I might get protection. This was successful on all but two nights. In early June of this year I decided to take another tablet at 7.30.a.m. every morning as I always have an attack at around 8.30.a.m. This was 100% successful. I have on a couple of occasions not taken a pill (deliberately) and got hit both times. There has been one trial over here in the UK on taking Sumatriptan pills as a prophylactic (preventative), however the trial was not timed in relation to the attacks, just one 100 mgs tablet taken three times a day, not a very efficient method of taking them as with a half life of 4 hours this only gives a maximum of 12 hours of protection a day if your lucky! The one certainty for many sufferers is that we are able foresee our attacks. It does seem to me that as the active ingredients in Sumatriptan tablets and Imigran injections are identical, in theory my use of Sumatriptan pills should work and also keeps my Doctor happy ‘cos they cost a lot less. I have been virtually attack free for the first time in 20 years of being chronic other than the odd mild attack at 8.45. in the evening. which I clear with a high energy drink. It also seems that unlike Frovatriptan its effectiveness doesn't diminish. Regards Mike OUCH UK Trustee

     Very cool.

      Potter

This is the ONLY way Imitrex pills worked for me in the past.  I use to take one before bed and one before work and was essentially cluster-free, but as the beast changes his course of destruction, you'll have to dial it in again to fight him at the appropriate time.  This is affective, but as we all know, too much Imitrex can cause rebound clusters.  Good tip!

My last Neuro had me taking Amerge before bed (I always get hit 45 minutes after going to sleep) then about 10:00AM - just ahead of my usual 11:00AM hit.

After having my heart checked out, he also had me using Zomig NS for the few hits that did break through.

This routine actually worked quite well - until I ran out of money................

Marc

Interesting that Marc, the neurologists over here will never use Amerge for CH and I know Prof Goadsby says it's useless for CH. Are the Sumatriptan pills expensive in The US? 

Mike,

Never heard that before. Amerge is a Triptan, it is just newer and offers a longer half life than Sumatriptan.

I've tried them all, and for me Amerge is much better as a "mini preventative" than any of the other long lasting Triptans like Frova. Based on over 13 years of being chronic, I will argue effectively that Amerge is quite effective for me.

However, all of the tablet forms of Triptans are useless to me for aborting a hit in progress - way too slow. Their value is in avoiding a regularly scheduled hit.

Yes, all of these medications are expensive.

I very rarely need any abortive since I learned to use oxygen at 25-35 lpm because it kills virtually every hit within 3-6 minutes.

Marc

Marc, actually seems like the jury's out as I google Amerge cluster headache and found a few recommendations for it and many against it, found this one on drugs.com
Amerge should be used only for acute, classic migraine attacks. It should not be taken for other types of headache, including cluster headache and certain unusual types of migraine.
If it works for you that's great.

I've been using Amerge for years now as a preventative just before bed in order to get one full nights sleep and it's always worked like a charm. 

I don't do it often though.  Only when it's been days since I had more than 2 hrs. of sleep a night.  I have recommended that to others it it has worked for them also.

A lot people haven't caught up with the facts about Triptans being used for CH's.

I heard about the great effectiveness of Amerge as a "bedtime preventative" from many other Clusterheads on this board back in 1999.

Remember that Sumatriptan was not approved for CH's until much, much later.  :)

Eventually, the rest of the medical community catches up with what Cluster headache suffers have known for years.

A prime example is high flow oxygen therapy. Many, many of us have found a darn miracle at 25-35+ liters per minute. So much so, that we don't need another abortive medication anymore. Eventually, the mainstream medical community will recognize that some people need that high flow in order to get almost instant relief. But for now.............nope.

Marc

Quote:

Remember that Sumatriptan was not approved for CH's until much, much later.

I first used Imigran in 1992, the injector was a lot bigger than it is now, obviously it must have been licensed here earlier than in The States. As I get them on the NHS for free there is no limit as far as cost is concerned and I was using two a day every day for many years.   

Nice work my friend.  8-)
Damned if the same thing doesn't work for me except for the fact that I do the same thing with my trusty O2.  I, like you suffer accurately timed attacks. This year it's been 5.30pm, 9.30pm and usually 1 hour after falling asleep.  I am on a preventative (Verapamil) which has taken the edge off the afternoon and early evening attacks, but the one after sleep was a cracker.  Anything from kip 8 upwards.  Figured it was because the beast had already got his claws into me before I could abort with the O2.  My wife ( ex nurse ) suggested a 5 - 10 min session on the O2 immediately before going to sleep.  BINGO.......10 nights now and ooohhhhh so heavenly sleep.
Nice to here there are others plotting to kill the bastard,  nicely done  ;D

As a trustee of OUCH UK I speak to loads of GP's and neurologists and unfortunately their training seems to make them very fixed on the way to treat CH sufferers. They are unable to think laterally, it seems its up to us poor sufferers who need to push them. They wouldn't think of using triptans or O2 on a timed prophylactic basis and if you suggest that high energy drinks help many of us the look at you as though you are mad.