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What can I expect from migraine abortives? (Read 883 times)
Martin
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What can I expect from migraine abortives?
Sep 21st, 2009 at 4:53pm
 
Hi, Got back from the MD this afternoon.  I explained my CH symptoms, and he at least had heard of it but admitted he didn't know much about Clusters.  He gave me some Migraine meds to abort my next headache, and told me to keep in touch and let him know how they work.  So, will these work on clusters?  Or is this just one more wasted delay before I can get some proper abortives and some 02?

Relpax 40 mg (eletriptan hydrobromide)
Maxal RPD 10mg (rizatriptan benzoate)

are what I got.
Triptans any good?  Should I have any hopes for these meds next time I get hit?
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Lottie
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Re: What can I expect from migraine abortives?
Reply #1 - Sep 21st, 2009 at 5:23pm
 
Triptans are good for CH, but for most clusterheads pills work too slow.
Imitrex injections are most common for CH, but it's also available in a nasal spray. Both work a lot faster than the pills.
But the main abortive for CH is O2. It really makes all the difference, with zero side effects, no matter how much you have to use it in a day. So I would talk to your doc about O2.
Read the oxygen link on your left, it's great info if you're new to O2. You'll know what you're talking about to your doc. And if he's willing to learn about CH, he should do some research for himself.

Lottie
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Bob Johnson
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Re: What can I expect from migraine abortives?
Reply #2 - Sep 22nd, 2009 at 1:37pm
 
It would help you to learn more about CH and treatments.
========

 
Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
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Bob Johnson
 
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