What's so bad about mixing triptans? Couldn't you take a Frova to stave off a night attack and use Trex injector or oxygen if it breaks thru?

lennycohen wrote on Jun 24^th, 2010 at 11:29pm:

What's so bad about mixing triptans? Couldn't you take a Frova to stave off a night attack and use Trex injector or oxygen if it breaks thru?

Oxygen is OK. Use of different triptans in a 24 hour period can result in serious complications.

It depends on how badly you want to live.

Jerry

It should not be done without express consent of your supervising doctor, and I think your doc would want to do a cardio work-up on you first. To make sure your ol' ticker can handle it.

You are treading on thin ice so to speak.  It is very complex but the heart usually just can not handle it.  It says in the insert that you are not to mix them.  Please talk to your dr about this before you proceed to do it again.  We want you around for awhile.

Make no mistake - a healthy heart CAN handle it, but which kinds and how much should be something you AND your doctor discuss before doing it.

I'm living proof that it can work, and work well. My neuro had me on a prophylactic dose of Amerge for several months while using Maxalt when needed for breakthrough attacks. But you must insist on a thorough cardiac work-up first.

Thanks for the replies - I actually haven't tried it yet, but I'm trying to think of all the options, I'm back up to 3-4 kip 7+ / day ---- started lithium this morning ---

It seems like I remember several years ago that we had a member that actually had a stroke from doing this. I was very new to the board at the time but I do remember reading something about it. Maybe some of the veterans around here could chime in on this subject.

ok, my initial reaction from reading this thread was 'AHHHHHHH!!  AHHHHHH!!!'

But on further reflection, I'm thinking it would depend on your cardiac risk factors (age, diabetes, smoking, hypertension, etc.) and how much total triptan you're taking.

Essentially, you have to make sure not to go over a total triptan dose maximum - i.e. imitrex oral is 200mg/d max - if you took an oral tab of 100mg and later an inj, I'm thinking then you would reach your daily max, but not necessarily over it - this may still hold true even with cross scripts of tripans.  still scary though...

Please, make sure you get a cardiac work-up - EKG and discussion of risks at the very least and I would actually recommend a stress test - insurance would likely cover it under a diagnosis of 'starting high cardiac risk medications'

There are a lot of cases of mixing triptans for various results in the medical literature but the largest issue is the possibility of serotonin syndrome, which can cause serious issues and death.

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MJ wrote on Jul 3^rd, 2010 at 2:45am:

...which can cause serious issues and death.

Yeah, I'd say that's kind of a serious issue. ;D

i am using dihydergot tablets.
if you having a bad time you might consider this option too by maybe switching with it at least for a while.
it doesn't give me any rebound headaches as imigran
i think it has longer effect and in bad periods of year
can take up to three tablets with only side effect
a sort of tiredness in hands and legs.
Maybe it could work along with a coffee or energy drink at least for a while as you haven't get used to it?
just an option but you know how these work.
always discussing first with a neuro. ;)

Quote:

can take up to three tablets

in 24 hours period!not all together
sorry for my language :-[

Thanks for all the input. 600 mgs of lithium/day has knocked it down considerably, been on for 12+ days, went from a constant 3-4 with excursions to 8, to a constant 1-2, with about a 1x/day excursion to 4 -- haven't used Imitrex inj or Sumavel for more than a week - we'll see how long this episode goes.

Great to hear that the liithium is working for ya like that Lenny.  :)

Lithium has been my best freind for many many years. I go at 1200 mg a day and it blocks up to 60-70% of my attacks. Used to use 900 but over the years it became ineffective at that level.

At 1200 mg even my wife doesn't notice any difference so if you end up having to increase don't sweat it. Damned glad you're getting relief that's great news.

Joe

oh, hooray!!!
:D