I have been on Duloxetine for about 6 weeks now, 30mg for 1 week and 60, my neuro has told me to double dose but I'm anxious as I've never had such bad attacks like this (8 a day) this last week.  now been prescribed Imigran injection and morphine patches, anyone else have eny experience on duloxetine or imigran??? - I know alcohol is a trigger for a lot of people but sometimes a large vodka and coke or 2 can give me 4 - 6 :D hours of relief!

Imigran is the same as Imitrex just a different name, the medical name for the drug is Sumatriptan Succinate.

I am on the Imitrex shots and the nasal as back up, Imitrex will sometimes give you a tightening feeling in your throat or bass of your neck but other than that I've had no adverse side affects from it.

I strongly recommend no alcohol and to avoid the morphine as it is addictive and will more than likely cause more problems with your CH hits.  I would find a Headache specialist or at least go to a different neurologist for a second opinion on your treatment options.

I have no experience with Duloxetine, but I'm sure someone else here can and will help with that.

Good Luck!

hi Carolyn!
Welcome!
I'm going to be straight forward and say that I'm a bit confused about what your neurologist is doing...

He has you on Cymbalta (Duloxetine) - med usually used for depression but may also be used for fibromyalgia or diabetic neuropathy (I don't know of any specific CH use except perhaps in treating the depression that CH can bring).  But he is just now starting sumatripan (imigran/imitrex) and also plans Morphine patches?!  Are you supposed to start the patches when your h/a starts or just wear it all the time?

I'm feeling like there may be some piece of the puzzle that we're missing here...  Do you have chronic pain besides the CH?

Have you tried any of the preventatives such as verapamil, gabapentin, lithium, etc?

I agree with above. (except for Gabapentin)
Unless the doc is treating you for much more than CH he is misguided in his treatments and has little understanding of cluster headaches.

The treatments have every possibility of increasing the pain, frequency of hits and a long term income for the doctors practice. There remains a very, very slim chance it might help one in 1,000 with CH

Cymbalta is a oral dual reuptake inhibitor that enhances the levels of the neurotransmitters, serotonin and norepinephrine
START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Vodka and coke. The greater benefit may be in the coke alone. Most stimulants ie; caffeine can be beneficial and the fizzy (Co2) can help a wee bit as well.

Most depressives ie: narcotics, morphine, valium, etc.. have an adverse effect on CH. in 999 of 1000 cluster heads.

I've never had any other chronic pain or depression, I'm happy as Larry inbetween attacks (well as happy as you can be!). The morphine strength in the patch is 5mg to be worn for a week at a time.  I'm very wary about duloxotine and need to speak to my doc.  I really don't fancy doubling the dose.  I'm in terested in trying the imigran injection, I get them today.  I have been referred to another neuro to maybe discuss ONSI.... But that sounds terrifying!

Immitrex/immigran injections can and do help a lot of people but they are not without side effects.

Of any drug you mention this is the only one I would be comfortable with.

The ONSI treatments are all the rage in parts of the medical community but in reality benefit very few with CH. If they do benefit it is generally short lived.

Might be a good idea to get another opinion from an unaffiliated doctor.

Or if you like the doc you have gather as much data as you can and help him/her learn about CH.

My doc has been doing research and she questioned the duloxotine with my neuo, which is why i need to see doc to question morphine,   quite excited about trying imigran, heard a lot of good results from it.  and I slept for 7 hours last night, and havent had an attack for 9 hours  ;D

Can I just say also.... it's great to talk to other sufferers, as I know no-one else with this affliction :)

Morphine is a quite inappropriate med for Cluster and suggests the doc is lacking training/experience in this area.

Look for a specialist:

LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.

2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE; On-line screen to find a physician.

5. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

6. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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If a new doc is not possible, print out the PDF file, below, and use it as a tool to discuss treatments.

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Carolyn wrote on Jul 3^rd, 2010 at 3:50am:

Can I just say also.... it's great to talk to other sufferers, as I know no-one else with this affliction

Not only may you say it, you can rejoice in it! It's something to rejoice over, anyway. Welcome and learn as much as you can before going to your neuro...and bring documentation. Blessings! lance

Carolyn wrote on Jul 3^rd, 2010 at 3:50am:

it's great to talk to other sufferers, as I know no-one else with this affliction :)

Once you start talking about it, don't be surprised to come across other people. I've found out that someone from work and someone I was at university with both know just what it is like to suffer from CHs.

Welcome Carolyn!

I'm sure by now you seen enough here say to ditch the morphine and avoid alcohol?

Imigran should work fine if you use it right at the earliest signs of an attack. 

Ask you doc about oxygen.  It will change your life without any side affects.

Best of luck!

Chad