Back to whine cause I'm in cycle. I've had good success aborting about 75% of hits with sumatriptan nasal but am having a lot more hits. I've had a month long cycle every two years on average for the last 30 plus years. when i look back at how they've played out i almost always had the same number of really bad HA's per cycle.

Now that I'm using triptans and energy drinks i feel like shit between the HA's as well.(maybe the lack of sleep is affecting me more now.) I'm thinking about going back to the "man up" approach. My script for imitrex ran out and the doc re-upped it but my insurance company wouldn't pay for it. I could have afforded the $215.00 for six more sprays but the doctor said the ins. co. thinks i'm overusing and getting rebound headaches anyway. I 'm not sure i can argue that. I should be winding down my cycle and I can get the imitrex paid for on wednesday. But i also managed to abort a headache just with extreme cold on my forehead and extreme heat on the back of my neck. I need to try O2, but ins. co. won't help with that at all. Would o2 have a better success rate with no rebounds?

o2 --- No rebounds, good success rates

2nd night of 'manning up' didn't work out too well. it did remind me that even when the imitrex doesn't abort an attack it still takes a little edge off. the 10's i thought i was having were really 9's. last night was multiple 10's. been off imitrex for 3 days so i don't think there is any rebound. i think my head is just not right.

bought a regulator. called a neuro office. my cycle will probably be done before i can get any help but i can't count on my lengthy remission periods to bail me out of this. this cycle is kicking my ass.

Are you using preventive med? If not, why not.

Timing on using an abortive is crucial. Don't want to delay usin in hopes it will resolve or waiting to see if a full bore attack developes.

Explore trying this med as an abortive. Much less $; rapid on set. Only disadvantage is whether you would have to use more than aboutg 1x/day. Print and discuss with your doc. It has been a 100% success for several of us; pill, so easy to carry/take.
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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

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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.
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Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ]

My two cents - again - is the neither the nasal or the pill worked worth a dang for me.  The only 100% abortive that works for me is the injection.

Also - for me, I have decided that the triptan does not casue rebounds. (have done the "man up" test twice for confirmation). If I have essentially back to back headaches it just means the trex 1/2 life was over and another dose was needed - or I was going to get another hit anyway.  Also - I have used above the 2/24 hr max with no side effect other than an aborted CH.  My strategy now is - get as many injectables as I can stocked up, went with the pred taper and am taking verapamil for preventative.  Knock on wood, but going on two weeks without a hit.  Will buy another 24 injections in a month or so, and then another 24 a month or so later.   I will NEVER let myself run out again.  Even though the memory of this cycle is starting to fade - after my own experience and reading the experience of those on this board - I know the damn beast will come back someday.  I will be ready.

Get the script for the injections.  When the cycle stops fill as many as your insurance company will allow you to and load up.  And for gosh sake - at least give the pred taper and verapamil a try.

Good luck

After your cycle, keep getting the monthly 4 shots that they will pay for. Stock em up.

Coach Bill

Get the O2...do not pass go, do not collect $200. Just do it. You need as many abortives in your arsenal as possible. And why no preventative? blessings. lance

Stocking up on abortives that work is an essential part of being able to fight the beast !!

I feel for you.  I, too, have played the game with the injectables.  One thing I did learn here was how to split the doses.  When I couldn't get 4mg doses, I got the 6mg ones and thought it was over medicating to shoot the additional 2mg if the 4 was working well.  Then someone here (and thank you again) wrote something about getting syringes and finding the lowest effective dosing.  I am surprised that I can use 2mg with great success most of the time.  Coupled with the O2 clout, I am now stockpiling.  Helps me sleep better at night.  Just a little CH humor there.