Anyone ever try crushing a pill and taking it like a BC powder?
Or dissolving one in water?
Running out of abortives and neuro is on vacation.
Down to 3 injections, 5 nasal sprays,but have lots of tablets.

     I take 50 mg of Imitrex at bedtime to get 4 to 7 hours of sleep depending how bad my cycle is.  The limit is 200 mg per day but I've never taken that much. It seems that we're not supposed to take it as a preventative but I've used it successfully as such for years. The catch is the morning monster you're likely to get and if you don't have oxygen as an abort it is often a pretty bad one.  Are you on the D3 regimen?.


                         Good luck,  Sean

Why use Imitrex as a preventive when there are less expensive and far more effective meds for this purpose?

See the PDF file, below.

Most docs have a back-up to cover their patients when they are away. Have you asked his staff what your options are for refills, etc.?

I suspect that grinding up a pill would reduce it's effectivenss because stomach acid neutralizes it, as it is, and small bits wold likely be neutralized more quickly.

---

Never thought about that Bob.
Just trying to take what I have and make it work.
Thankfully,I talked to my neuro yesterday,and after a little begging,he gave me a little prednisone taper, and increased my verapimil .
I can already tell a difference.
He's also set aside some samples for me to pick up on Friday.(has always been generous with those)
I'm between jobs and can't enroll in my new employers insurance until January .
The great news is from my conversations with other employees,is its affordable,company pays 50%,and is pretty good insurance .
I'm thankful my dr listens to his patients,and works with my budget.
Yes Sean,I took the d3 regimen for 2 years, and I was pain free for most of that time.
This particular cycle has been vicious,and at the behest of my dr.,I resumed the verapamil .
I have an EKG appt on Monday with my PCP and I will ask for a blood test to check my levels while there.

Having difficulties posting.
Bob the number I had for emergencies ended up being an on call doctor at the local ER.
Completely clueless.
I did get a neurologist after several call transfers,to which he replied I would have to be seen.
At the hospital.
One that is in another city 1 1/2 hours away.
I could go to my local hospital if I needed to do that.
Clueless.

Hi Bob,
           It's an interesting topic the use of imigran or imatrex as a preventative.
My 50 mg imigran cost me about $4.oo each. When I was dosing up on unbearable amounts of verapamil, and the hits kept coming all thru the night, A simple 50 mg tablet gave me my first sleep in over a week, cost just simply doesn't come into it. I know it works for a few people here. While I'm sure there are cheaper or indeed other preventatives that can work, most of the time, nothing stopped those wake up hits through the night.
Without fail, every time I take one, about 11.00 pm before bed, I have never been woken with a hit, I've never really had to do it for more than two or three nights in a row, I've found it throws a curve ball to the beast ! so it really is, considering the value of sleep and how the lack of it truly effects the cycle more, including the ramifications at work the next day, an absolute godsend for me !  even if the tablets were 5 times the price, wouldn't make one bit of difference, I'd keep with the same strategy.
Not for everyone I suppose and not recommended, But I choose to use what works and gets me through a cycle, not what a neurologist that's never endured a cycle feels is best for me.  It might not work for everyone, not sure, but I know quite a few people here have it as a strategy...

cheers
colin

Sean and blacklab, me too. Hoppy suggested it to me, so I gave it a try. I will now get woken by my first hit around 5 am, which means I have had a few hours sleep. The directions in the packet make it clear that you shouldn't do this, but as we all know there is so little help which is readily available (if any) for us, so I do what I have to do to help myself. Obviously I only take them when absolutely desperate for some sleep.They are not much good for anything else in my opinion because they take too long to work, but taken at bedtime it's just getting effective when the beast comes to call.

Bob Luckily for me, due to my age, they are now free (good old NHS) but even when I had to pay  it was around £7.50 for 6 tablets.(NHS price) Definately worth it for a weeks sleep.

Esheel I know how difficult and frustrating it is trying to find a doctor to help. You have to educate them yourself. I now have two who have listened to me and are now very helpful when I need them, and a third who is getting there. This latest guy told me that they have no training what so ever in this condition. He has another patient who has been diagnosed with CH, and he kept me for 20 minutes asking MY advice on what to prescribe for her. He should pay me !!! ;D  I always ask them to do a little research on the internet and learn what this thing is all about. If I can research it I'm sure a doctor can. I also direct them to this site where they can learn from the experts. ;D

If the D3 kept you pain free for 2 years - get back on it. It probably won't help this cycle but you'll be set up for next time.
Maz.

I use immigran tablets at night for another reason and, along with indomethicin, I'm quite sure it helps with CH when cycles coincide or overlap.

It might not be recommended but the pharmacist assures me it can't hurt.

Oh, blessed sleep!

I think I sense a bit of confusion about the use/dose of some of our most commonly used meds.

Standard protocol is:

1. Staring treatment with Prednisone. It quickly aborts an attack but has no long term effect. The dose is tapered down to zero over10-14 days.

2. At the same time Verapamil is quickly build up to final doses in the 400-900mg range. It serves for long term prevention of attacks and may be safely used for long periods. If you have regular, predictable cycles, you can stop a cycle has ended; with unstable cycles, you can stay on it full time. (With high doses, routine heart checks is recommended.)

3. For attacks that slip thru, a fast acting statin to kill an attack quickly--but not used as a routine med.--just to abort an attack.    See the PDF file, below.

---

Taking one before bed never helped me.
Always awake an hour or so after sleep with a banger.
Thankfully have had 2 full nights sleep with the prednisone taper.
Doc is back from vacation so I should get more samples tomorrow .
Worth the 3 hours round trip for those.
Worst thing now is the rebounds from the lack of imitrex in my system the last 2 days.
Had to take a half tablet earlier just to get it to go away for awhile.
50 mgs is better than the 200 on top of nasal sprays and injections in the middle of the night.
Wish my doc wasn't so pessimistic about O2.
He thinks they just delay it,putting it off at the time for them to come back stronger later.
That and he knows I smoke like a freight train during cycles.
Probably thinks I'll blow myself up !
I'll keep working on him though.
He's pretty good about everything else.

                  Amen to that Blessed Sleep, Brian.  Ain't nothing better than waking up in the morning and realizing you made it through the night without a single hit.

                                   Sean :)

Esheel
The attitude of some doctors toward 02 never ceases to amaze me. If you turn up at the ER with a stubbed toe they will shove an 02 mask on your face, yet they won't prescribe it for something that really matters. High flow 02 is a vasoconstrictor, which is exactly what imitrex is. I really don't understand thier logic in thinking that the very stuff man has breathed since the dawn of time can be more dangerouse than a bunch of nasty drugs with all the side effects they have.

Of course it comes back - that's the nature of the beast. It's not because you have used 02. If I use an injection it aborts the CH quickly, but it still comes back. And 02 will not cause them to come back stronger.  It's completely natural, you are not restricted on how often you can use it, and there are no rebounds. Your doc "thinks" 02 will just delay it but he doesn't "know". Ask him to let you find out for yourself. But remember you must have a minimum of 15 litres per minute and a non-rebreather mask or he will be saying "I told you so".

I've had 4 big tanks in the house for a couple of years now, and I smoke too - as does all my family. As long as you are sensible - don't smoke when you're using it or for 20 minutes after , or in the same room, don't store it next to the stove or  any open fire, etc,etc. They give it to doddery old people so there is no reason to with hold it from you. However, if you need to you can get welders 02 (but don't tell your doctor that)and buy a mask from this site. See the tabs on the left of your screen - "oxygen info" and "CH.com store". It's best not to tell the welding suppliers what you want it for either. Make up some story about your cousin making you a fence. ;D

The imitrex is more expensive and far more dangerous than 02. I use 02 when I'm at home and save the injections for when I'm out. Since having the 02 my use of the injections has been cut by 90%. If your doc is reasonable about other things I would really go to work on him and see if you can change his mind. I have discovered recently that a few dramatics often helps, beg and cry, and there's nothing better than actually having an attack right there in front of him. He's probably never witnessed any one having a CH, so it will scare him to death. Worked for me !!!

Good luck
Maz.

Lol maz.
My cousin did work for a fencing company once.
I can't complain.
Today he gave me his cell phone number and apologized for the lack of help I recieved while he was on vacation.
Call anytime he says.
He has seen his share of attacks I'm sure.
He tells me one of his patients tried to leap to their death because of these things.
He's just a little stubborn about the o2 for some reason.
I'll crack him !

So he's already had a patient who's life was reduced to abject misery and suicide attempts because of CH, and he still won't prescribe the safest, cheapest, most effective and widely used treatment there is. Jeeez !!!   :o

It amazes me that someone who is mega intelligent (must be to be a doctor) and very highly educated, can be so stupid. I bet if he had just one hour of CH himself, he'd soon change his mind. Shame there is not a pill that would bring it on, so he could experiment with himself instead of people who really need help.

Keep on at him till he gives in.
Maz

200% agreement with Maz's post.

How anyone can deny someone with CH access to oxygen is beyond me. Have they really read about the pain that a CH brings, which is beyond what the strongest narcotics can deal with and yet not understood the importance of aborting it via a really safe method, i.e. oxygen?

Perhaps I may be able to provide enough evidence on the efficacy of oxygen therapy as a CH abortive to convince some of the doubting neurologists who are hesitant to prescribe it to their CH patients.

I've spent the last 10 years studying different methods of oxygen therapy at flow rates that support hyperventilation (25-40 liters/minute).  I've also conducted a study with seven CH'ers using oxygen regulators capable of delivering 100% oxygen at flow rates of 0-60 liters/minute and with oxygen demand valves with flow rates up to 120 liters/minute (average flow rate of 40 liters/minute) to abort their CH...

For starters, any CH'er having difficulty obtaining an Rx for oxygen therapy from their neurologist needs to print out the following link and take it to their neurologist.

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This is the Guideline recommended treatments for Cluster Headache and other Trigemino-autonomic Cephalgias developed by a task force from the European Federation of Neurological Societies (EFNS). 

This task force was comprised of some of the brightest minds in the field of neurology and recognized internationally as experts in the treatment of cluster headache and other trigemino-autonomic cephalgias.  This task force included some very familiar names if you've read any cluster headache studies...  It includes Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, and Sandor PS.

I had the opportunity to meet with Dr. Arne May and spent two days with him at his facilities at the University of Hamburg.  I've also met with Dr. Peter Sandor at the 2009 International Headache Society Annual meeting in Philadelphia, PA, and I've met with Dr. Peter Goadsby at two OUCH conferences where he was our guest speaker.

Closer to home, I've spent the last 8 years working with Dr. Todd Rozen on more effective methods of oxygen therapy as an abortive for CH.  This work started initially at the Michigan Headache & Neurological Institute (MHNI), AnnArbor, MI, and more recently at the Geisinger Health System’s Neuroscience Institute, Headache Center in Wilkes Bare, PA.

All of of these experts prescribe oxygen therapy as the first abortive of choice and this is reflected in the EFNS recommended treatments in the link above illustrated in the following chart.

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The following chart from the 2008 study I conducted using oxygen therapy at flow rates that support hyperventilation illustrates the benefits of hyperventilation during oxygen therapy as a rapid and reliable CH abortive.

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During this study the seven participants, six chronic and one episodic, six men, one woman, collected data on every abort with high flow oxygen therapy for 8 weeks each.  This resulted in abort time and pain level data on 366 aborts. 

The overall efficacy was 99% in affecting an abort within 20 minutes, and an average abort time of 7 minutes across pain levels 3 through 9.

As you can see, oxygen therapy at flow rates that support hyperventilation results in abort times four times faster than at a flow rate of 15 liters/minute.

This study also revealed for the first time that the higher the cluster headache pain at the start of oxygen therapy, the longer it took to abort that cluster headache.   This should be reason enough to start oxygen therapy at the first sign of an approaching CH...  Waiting is only going to prolong the time to abort.

You can improve the above average abort time or eliminate the need for oxygen therapy completely by starting the anti-inflammatory regimen with 10,000 IU/day vitamin D3 plus the vitamin D3 cofactors and Omega-3 fish oil.  See the following link for details:

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Hope this helps.

Take care,

V/R, Batch

Bob Johnson wrote on Sep 10^th, 2015 at 11:34am:

I think I sense a bit of confusion about the use/dose of some of our most commonly used meds. 3. For attacks that slip thru, a fast acting statin to kill an attack quickly--but not used as a routine med.--just to abort an attack.    See the PDF file, below.

Bob--When you are talking about the statins are you talking about the Somatastatin and Octreotide that this PDF talks about or are you talking about the group of drugs referred to as "statins" that are usually prescribed for high cholesterol?

-Ricardo 

Hey Ricardo,

The "fast acting statin" comment got me going too...  A quick check revealed  "Somatostatin" is not a Statin... (a family of cholesterol lowering drugs that no one should ever take IMHO)... but it is a hormone that inhibits the secretion of several other hormones, including growth hormone, thyroid stimulating hormone and a long list of other hormones...

Somatostatin (SST) also known as somatotropin release-inhibiting factor (SRIF), it's a hypothalamic hormone, a pancreatic hormone, and a central and peripheral neurotransmitter... See the following link for an excellent write-up on Somatostatin and what it does...

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Take care,

V/R, Batch

I understand that in the UK you have the right to by-pass your local docs and be referred to a heaache cllinis where the level of care is much better. (Many of the  comments we read from the UK complain about the lack of skill in local docs aroud Cluster.)

You have an excellent support group to guide you on a move to a headache clinic.
--
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