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Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Sumatriptan nasal versus injection http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1349915931 Message started by retrovertigo on Oct 10th, 2012 at 8:38pm |
Title: Sumatriptan nasal versus injection Post by retrovertigo on Oct 10th, 2012 at 8:38pm
I am currently out of cycle, but I am stockpiling meds for my next one since I always run out of imitrex and the ins. co. won't refill the script quickly enough. I had been using the nasal spray with so- so results and been wanting to try the injection. My doc agreed to write me a script but when I had it filled they only gave me two shots ( as opposed to six sprays). I figure I can get my stockpile to where I need it but I will have to be very diligent about it. For those who have used both- is it worth it? Or am I just making more work for myself? Or do I put my efforts into O2?
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Title: Re: Sumatriptan nasal versus injection Post by Budbuds Mommom on Oct 10th, 2012 at 9:06pm
I use o2 to abort then imitrex to keep it away. If I use just imitrex only they usually just continue to get worse. But on the other side the spray doesnt work unless I catch it before it comes. I have a red splotch that comes up next to my eye on my ch side before they come sometimes. So that helps
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Title: Re: Sumatriptan nasal versus injection Post by LasVegas on Oct 10th, 2012 at 9:08pm
Imitrex injections are far more superior to nasal spray.
You mentioned you can get 6 nasal sprays, but only achieve so-so results, right? What if you could get the 2 injections you mentioned, turn it into 6 aborts and with excellent results; would you switch to injections instead of nasal sprays? Of course! ;) Read the Imitrex tip (yellow tab on left side of your screen) and you will understand how to achieve 3 for 1 or in your case, 6 for 2. If you have difficulty understanding, PM me with your phone # and I will walk you through it. Smart thinking to stockpile 8-) -Gregg in Las Vegas |
Title: Re: Sumatriptan nasal versus injection Post by Bob Johnson on Oct 11th, 2012 at 6:39am
Suggest you print out this material and discuss options with your doc.
===== Headache. 2005 Sep;45(8):1069-72. Treatment of Cluster Headache Attacks With Less Than 6 mg Subcutaneous Sumatriptan. Gregor N, Schlesiger C, Akova-Ozturk E, Kraemer C, Husstedt IW, Evers S. Background.-Subcutaneous (SQ) sumatriptan 6 mg is effective in the treatment of acute cluster headache attacks. However, patients sometimes benefit from a dose less than 6 mg. Objective.-Therefore, we designed a prospective open study to evaluate how many patients benefit from a dose less than 6 mg SQ sumatriptan. Methods.-We enrolled 81 consecutive patients with cluster headache and recorded their use of SQ sumatriptan and oxygen. Patients regularly using SQ sumatriptan 6 mg were advised to treat attacks with doses less than 6 mg and with oxygen. Efficacy and side effects of the different treatment options (6 mg, 3 mg, 2 mg, and oxygen) were evaluated. Results.-As a result, 74% of the patients using SQ sumatriptan 3 mg showed efficacy and 89% reported efficacy after 2 mg. Seventy-nine percent reported side effects after the use of SQ sumatriptan 6 mg (29% severe side effects). After the use of 2 mg SQ sumatriptan, only 50% of the patients reported side effects, none of these were classified as severe. Patients' preference was 41% for 6 mg sumatriptan, 28% for doses less than 6 mg, and 31% for oxygen. Conclusions.-We conclude that sumatriptan in doses less than 6 mg can be effective in the acute treatment of cluster headache attacks. We suggest that patients should have experience in their individual efficacy of sumatriptan doses less than 6 mg. (Headache 2005;45:1069-1072). PMID: 16109122 ================== This med has several advantages: almost as fast as Imitrex; pill so easy to carry and use; cost per dose is much less so that insurance may not be a barrier. The only disadvantage is that total daily/weekly dosing needs to be limited but still worth a trial to see how our body responds. (After I discovered Olan. it became the only abortive I used. The dramatic speed of relief was a bit of magic for me!) ------ 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. ===== Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ] |
Title: Re: Sumatriptan nasal versus injection Post by wimsey1 on Oct 11th, 2012 at 8:15am
I had no joy with the spray form but the injections do act quickly. I have had good success with DHE spray (as in Migranal) which does not act as quickly but tends to last longer. As you say, it's important to build up your arsenal now. God bless. lance
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Title: Re: Sumatriptan nasal versus injection Post by Shedz on Oct 11th, 2012 at 3:04pm
I'd say injections every time, they work well for me when the 02 just isn't. If you're stockpiling the injections though, please be aware of the use by dates ;)
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Title: Re: Sumatriptan nasal versus injection Post by LasVegas on Oct 11th, 2012 at 4:02pm Shedz wrote on Oct 11th, 2012 at 3:04pm:
I completely disagree about expiration dates. Last year I used Imitrex nasal sprays and injections and Prednisone and Verapamil that have been expired over FIVE years and all of them were very effective. Aborts with Imitrex injections within 60 seconds, sometimes 30 seconds! Expiration dates do have some merit with some drugs, but generally speaking I have found that the expiration date is only labeled as an FDA requirement, specifically to help big pharma continue their racket. Keep in a cool, dark place, unopened, away from moisture and Imitrex will be as good as new...five years past the expiration date. Go stockpile! ;) -Gregg in Las Vegas |
Title: Re: Sumatriptan nasal versus injection Post by ttnolan on Oct 11th, 2012 at 7:53pm
I would vote for both in this order of priority...
1. Oxygen, oxygen, oxygen! This is faster for me with zero side effects. It properly keeps Imitrex shots available for emergencies... when I can't get to O2, like air travel or business meetings. 2. Imitrex, worth the effort! And yes, stockpile! With multiple letters from my doctor and a lot of whining on my part, the most I could ever get from an insurance company was 9 shots a month. And, I had the best insurance money could buy. For a brief time with one insurance company, I was able to get it up to 18, but that only lasted for 2 months before someone else at the insurance company shut it down. So, get your refills diligently, ask for samples from every doctor you see, and try out the imitrex tip link on the left. What about preventative medications? Taking any? |
Title: Re: Sumatriptan nasal versus injection Post by IndianaJohn on Oct 12th, 2012 at 7:38am
I use the nasal sprays with usually good results.
I stock pile too, when I am out of cycle. |
Title: Re: Sumatriptan nasal versus injection Post by retrovertigo on Oct 13th, 2012 at 11:18pm
Thanks for the advice. I'll go with the injections. I'm also working on getting O2, which i have never tried. Tough sell to the ins.co. and my family thinks it's dangerous.
Took verapamil for the first time last cycle, but started it late and not sure what effect it had. Prednisone doesn't work for me because i can't sleep when i take it, and losing sleep is one of the worst parts of being in cycle(besides the unbearable, excruciating pain). Its tough working out meds. I get a 6 week cycle an average of every two years. Trying to be more proactive when out of cycle because I can't get anything done when i'm in cycle. |
Title: Re: Sumatriptan nasal versus injection Post by ttnolan on Oct 14th, 2012 at 1:49am
It can be tough to even dial in what works in 6 weeks. Did that new med work, or did my cycle just end? It will drive you crazy. Get the oxygen, it is not dangerous, and if insurance will not step up, welding O2 can be had for less than you will pay in co-pays for the imitrex shots!
Edit: OK, I DON'T KNOW HOW THIS THREAD TURNED INTO A DISCUSSION OF TREX INJECTIONS VS NAISAL SPRAYS. THE QUESTION WAS EFFORT TOWARDS INJECTIONS OR O2? I urge you to read my previous post. I am the only one who correctly answered your question! Imitrex injections are not the best front line, first choice abortive. I still maintain you need BOTH! Imitrex shots have their problems... side effects, rebound headaches, limited number of uses per day, COST, and I could go on. It is a must for your arsenal when you can't get to your O2, but not something that works well as the sole abortive you will depend on. OXYGEN IS FIRST! |
Title: Re: Sumatriptan nasal versus injection Post by AussieBrian on Oct 14th, 2012 at 7:13am ttnolan wrote on Oct 14th, 2012 at 1:49am:
The title of the thread may give you a hint. |
Title: Re: Sumatriptan nasal versus injection Post by LasVegas on Oct 15th, 2012 at 10:32am ttnolan wrote on Oct 14th, 2012 at 1:49am:
I beg your pardon, as everybody who replied to this thread contributed excellent feedback and find your reply very insulting to all of us. >:( In fact, your pathetic quote above is the most arrogant statement i've read in 13 years on this website! >:( -Gregg in Las Vegas |
Title: Re: Sumatriptan nasal versus injection Post by ttnolan on Oct 17th, 2012 at 12:09am
Thanks for the reality check guys...
I guess I get too frustrated some times when I think important stuff is getting brushed aside. Should just log off. |
Title: Re: Sumatriptan nasal versus injection Post by ttnolan on Oct 17th, 2012 at 7:03am
OK, knowing when to walk away has never been my strong suit...
We have a young man here who has never tried oxygen, let's see what he has had to say... retrovertigo wrote on Mar 10th, 2009 at 7:12pm:
retrovertigo wrote on Mar 10th, 2009 at 7:41pm:
retrovertigo wrote on Mar 14th, 2009 at 9:52am:
retrovertigo wrote on Mar 14th, 2009 at 7:06pm:
retrovertigo wrote on Oct 7th, 2010 at 8:17am:
retrovertigo wrote on Oct 7th, 2010 at 6:31pm:
retrovertigo wrote on Jul 16th, 2012 at 9:09pm:
retrovertigo wrote on Jul 17th, 2012 at 6:01am:
retrovertigo wrote on Jul 21st, 2012 at 3:12pm:
retrovertigo wrote on Oct 10th, 2012 at 8:38pm:
Well should he put his efforts into O2? Is there anyone out there who can look past my rude meltdown and make a constructive comment regarding my stand on Imitrex injections and oxygen? |
Title: Re: Sumatriptan nasal versus injection Post by ttnolan on Oct 17th, 2012 at 7:29am retrovertigo wrote on Mar 14th, 2009 at 9:52am:
One intense hit and cycle ended... sounds familiar. I would revise my recommendations to add busting materials, and try that first with the oxygen as backup before even considering the Imitrex in any form. |
Title: Re: Sumatriptan nasal versus injection Post by Kevin_M on Oct 17th, 2012 at 7:47am
There were two questions, the first being which way to go with Imitrex.
Quote:
Las Vegas answered convincingly for getting the injections and using the Imitrex tip. A second drift had oxygen as an added option. Quote:
You made a good case for making oxygen a priority, too. The two questions went on divergent paths and passed each other like ships in the night. I wouldn't bother with wrong or right here, more importantly the replies were helpful, just acknowledge each other's contributions - that was the slight. ;) With the togetherness, both abortives make up a good arsenal. Reconciliation aside, glad to have you onboard, tt. :) |
Title: Re: Sumatriptan nasal versus injection Post by retrovertigo on Oct 19th, 2012 at 8:16am
tt is correct. I have never tried O2 as an abortive despite being a pretty resourceful person. In the past I asked others for help when I was mid-cycle and largely unable to help myself. My father-in-law who had unlimited supply of O2 offered to set me up but he passed away and the ins. co. quickly scooped up his bottles. My father who is a mechanical engineer and welder offered to get me a tank, then balked when he heard what the recommended flow rates are. He thinks that volume of O2 has to be dangerous. Obviously, he has never had cluster headache.
But I really have no one to blame but myself for not setting myself up when out of cycle and I am determined to not make that mistake again. One of the first steps is to keep coming to this site to gather information. |
Title: Re: Sumatriptan nasal versus injection Post by wimsey1 on Oct 19th, 2012 at 8:36am
Hmmm...it is sad when something as vital and effective as O2 becomes a point of debate between us and the unknowing public. Your father sounds like a smart guy. If you need his help, just say so; beg if you have to. Download some of the O2 info here and elsewhere that describes how safe it is to use. But whatever you must do, do! As to one versus the other, I use both for different reasons. As I said, Zomig did not help me at all although injections do help. Migranal does help, lasts longer than trex injections, but takes longer to take effect. Build up your arsenal and attack the beast. Whatever it takes. blessings. lance
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