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Marc123 CH.com Newbie Offline Posts: 20 Hatfield,Pennsylvania Gender:	Imitrex Question Oct 1^st, 2009 at 1:17pm Does anyone know if taking an oral dose of Imitrex before you go to sleep will help? I usually fall to sleep around 11:00 pm and my headaches have been happening around mid-night. I'm not too experienced with taking Imitrex so I wasn't sure if this was worth a shot or not.
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Chad

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Re: Imitrex Tip
Reply #1 - Oct 1^st, 2009 at 1:27pm

If you take Trex before bedtime, you should see results.
This is probably the only time the pill form will work. Taking a pill to abort usually doesn't work. Well, at least for me.

I heard of others here using Amerge which I am not familiar with other than it is another triptan.

Most of the time we're screwed if waking with a hit unless you have O2 by your side. It's all about timing.

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Marc Ex Member Gender:	Re: Imitrex Question Reply #2 - Oct 1^st, 2009 at 2:21pm Yes, several people here report success using Imitrex at bedtime.
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Marc123

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Re: Imitrex Question
Reply #3 - Oct 2^nd, 2009 at 7:44am

Well, it seems taking the Trex tablet before I went to bed last night worked for me. Took it around 10:30 and I slept through my usual wake-up times. Only woke up when my son started to cry. I just feel like I have some shadows hanging about this morning, but as long as they don't get any worse, I can manage. Gonna try it again tonight and hopefully it will work again.

How long do you guys think I should do this before I stop to see if the cycle is broken and over?

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« Last Edit: Oct 2^nd, 2009 at 7:57am by Marc123 »

"I get by with a little help from my friends" The Beatles- 1967

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Chad CH.com Hall of Famer Offline Posts: 738 Emmaus, PA Gender:	Re: Imitrex Question Reply #4 - Oct 2^nd, 2009 at 9:21am Marc123, I don't have any answer, but you must read on here about taking too much Trex. You can have rebound headaches or prolonged cycles it seems. I take very small doses and only while at work to get through the day. I'll be getting O2 in December when I see my new neuro. I am in remission right now though.
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DennisM1045

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Re: Imitrex Question
Reply #5 - Oct 2^nd, 2009 at 9:24am

Hi Marc,

I'm glad you got some rest. That can make everything seem better Wink

I'd like to post a note of caution though. In fact, some unlucky few have reported that triptan overuse can cause an increase in the frequency and intensity of attacks. So please be careful with this approach.

It has also been reported that overuse of Imitrex can lead to the drug becoming ineffective. Fortunately there are other triptans options that one can turn to. However I am unaware of any study covering long term use of triptans as prophylactic treatment.

Like everything else, what works for one does not work for all and I'm not saying "don't do this". I just want you to be aware of the pitfalls.

Having said all that I'd be willing to drink bat piss if it would take the pain away so I'm not going to knock anyone for trying anything.

Whatever you decide, please make sure your Dr is on board with this treatment plan and monitors your progress. Triptans are used safely by millions. But they are powerful vasoconstrictors and need to be used within established guidlines to be used safely.

The info I have found covers the use of Naratriptan (Amerge) and Eletriptan (Relpax) for some short term relief.

Naratriptan:

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Naratriptan in the prophylaxis of cluster headache.Loder E.
Harvard Medical School , Boston, Mass 02114, USA.

A 36-year-old man with cluster headache refractory to trials of standard prophylactic treatment and only partially responsive to parenteral sumatriptan and inhaled oxygen was admitted to an inpatient pain unit. The diagnosis of cluster headache was confirmed by direct observation of a typical attack. Despite efforts at prophylaxis, the patient continued to experience three to four severe headaches per day. Attempts to control his headaches with scheduled parenteral dihydroergotamine were successful, but headaches recurred when the medication was tapered, and continuous or intermittent use of parenteral dihydroergotamine was not felt to be a practical option for the patient. Naratriptan 2.5 mg twice daily completely abolished his headaches, which recurred when the medication was discontinued. No electrocardiographic or laboratory abnormalities were observed during treatment, and the patient reported no side effects.

PMID: 12005276 [PubMed - indexed for MEDLINE]

Eletriptan

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Eletriptan for the short-term prophylaxis of cluster headache.Zebenholzer K, Wöber C, Vigl M, Wessely P.
Department of Neurology, University of Vienna (Austria) Medical School.

BACKGROUND: A beneficial prophylactic effect from eletriptan 40 mg given to a single patient with cluster headache was observed. OBJECTIVE: To further evaluate the efficacy of eletriptan in the short-term prophylaxis of cluster headache. METHODS: We treated 18 patients; mean age, 40.5 years (standard deviation [SD], 9.9). The number of cluster headache attacks was recorded during a baseline period of 6 days, and during 6 days of treatment with eletriptan 40 mg twice daily. The primary outcome measure was the reduction in the number of attacks during the treatment period. RESULTS: In the 16 patients who completed the study (2 patients were lost to follow-up), the mean total number of attacks decreased from 10.9 (SD, 5.6) during baseline to 6.3 (SD, 3.7) during treatment with eletriptan (P=.01) The reduction in the number of attacks exceeded 50% in 6 patients. CONCLUSION: This small open-label study suggests that eletriptan 40 mg twice daily may be useful for the short-term prophylaxis of cluster headache.

PMID: 15109360 [PubMed - indexed for MEDLINE]

Good luck...

-Dennis-

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Marc Ex Member Gender:	Re: Imitrex Question Reply #6 - Oct 2^nd, 2009 at 10:00am Based on my own experience, I agree completely with the comments Dennis made. My approach would be to try using high flow O2 to abort, and turn to a Triptan only as a last resort. Marc
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Marc123

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Re: Imitrex Question
Reply #7 - Oct 4^th, 2009 at 9:52pm

Well, I've been taking the Trex before I go to bed and it gets me through the night. Only problem is that I've been getting 1-2 hits during the day. So last night I decided to see if the cylce had changed times and didn't take the Trex before bedtime. Wouldn't you know it I had a hit in the middle of the night. I took the pill and 15 mins later I was able to get back to bed.

I guess I'll keep taking the pill before bed. I'd rather sleep through the night and deal with this stuff during the day.

Getting blood work done tomorrow, I'll let you guys know what the results are.

~Peace out

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DennisM1045 CH.com Alumnus Offline One wave at a time! Posts: 3437 Haverhill, Massachusetts, USA Gender:	Re: Imitrex Question Reply #8 - Oct 5^th, 2009 at 12:31pm Marc123 wrote on Oct 4^th, 2009 at 9:52pm: Only problem is that I've been getting 1-2 hits during the day. Hi Marc, Sorry to hear of the increase in frequency. Is it normal for you to experience hits during the day? -Dennis-
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Marc123

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Re: Imitrex Question
Reply #9 - Oct 5^th, 2009 at 3:04pm

Before I realized I was in a cycle, I had a few little headaches that went away in a few mins. But when I realized this was a cylce starting up, I think my headaches just happened at night.

Is it possible that since I'm missing my 2 a.m. hit because of the Imittrex, that my body is basically "rescheduling" it for 2 p.m.?

I picked up some melatonin 10 mg tabs, going to take that intead of the Trex tonight and see how that goes. I'm assuming I'll need to let the melatonin build up in my system before it should become effective.

~Peace out

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« Last Edit: Oct 5^th, 2009 at 8:35pm by Marc123 »

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DennisM1045 CH.com Alumnus Offline One wave at a time! Posts: 3437 Haverhill, Massachusetts, USA Gender:	Re: Imitrex Question Reply #10 - Oct 6^th, 2009 at 7:48pm I just worry that using Trex is may be causing an increase in the # of hits you're getting. I'm not saying it's true but I have heard of this happening when using Trex daily. Can someone with direct experience of this effect chime in here with their experience? I sure don't want to under or overstate this. -Dennis-
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wip5150

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Re: Imitrex Question
Reply #11 - Oct 8^th, 2009 at 8:52am

DennisM1045 wrote on Oct 6^th, 2009 at 7:48pm:

Can someone with direct experience of this effect chime in here with their experience?

-Dennis-

Dennis,

During my last cycle, which seemed much more intense than past ones, I tended to rely more on Imitrex than I had in the past just to get through it. I will say that even though my cycle was shorter than normal, both the amount and intensity of the hits were more prevalent than in the past and I do attribute that to a bit of an over reliance on Trex. Seem that with each cycle I learn a little bit more and find better ways to corral the pain. Relying too much on Trex is a mistake I won't make during this cycle that just started up.

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Chad

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Re: Imitrex Question
Reply #12 - Oct 8^th, 2009 at 9:55am

Wip,

Good post reporting your results.

I limited my last cycle to 2mg worth of injections a day while at work using the "imitrex tip" from this site. That came down to 9 total days of 2mg injections at work. At home, I used energy drinks, melatonin at night, ice and excercise which was enough to fight it out. I should have O2 in December after my visit with my NEW neuro. I truely believe though that my limited use of Trex in this last cycle along with quitting smoking 5 years ago and using seeds before the cycle started made this the shortest cycle I have had in the 16 years I have been getting CH.

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« Last Edit: Oct 8^th, 2009 at 9:57am by Chad »

When the PAIN starts, I FIGHT back!

Rivea Corymbosa seeds were my KO punch, now D3 is the front runner!

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Marc123

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Re: Imitrex Question
Reply #13 - Oct 8^th, 2009 at 12:53pm

Well, I've been taking 10 mg of Melatonin before bed instead of the Imitrex and I didn't have any hits while I slept. I did keep getting a 2 pm attack that I would take a 100 mg Imitrex pill for and the pain would go away in about 20 mins.

Yesterday I was happy when I missed my 2 pm appointment and thought maybe I had broken the cycle and it was over, but unfortunately I had a hit last night around 12:30 am. Guess I'll see what happens at 2 pm today.

~Peace out

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Chad

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Re: Imitrex Question
Reply #14 - Oct 8^th, 2009 at 1:12pm

Marc123 wrote on Oct 8^th, 2009 at 12:53pm:

Well, I've been taking 10 mg of Melatonin before bed instead of the Imitrex and I didn't have any hits while I slept. I did keep getting a 2 pm attack that I would take a 100 mg Imitrex pill for and the pain would go away in about 20 mins.

Yesterday I was happy when I missed my 2 pm appointment and thought maybe I had broken the cycle and it was over, but unfortunately I had a hit last night around 12:30 am. Guess I'll see what happens at 2 pm today.

~Peace out

Marc,
I'm curious if you stopped taking your melatonin while you had that brief pain free time? I got a random hit last Thursday while being 5 days PF.

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When the PAIN starts, I FIGHT back!

Rivea Corymbosa seeds were my KO punch, now D3 is the front runner!

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Marc123 CH.com Newbie Offline Posts: 20 Hatfield,Pennsylvania Gender:	Re: Imitrex Question Reply #15 - Oct 8^th, 2009 at 2:42pm Chad, I haven't stopped taking the Melatonin sice I started this past Monday so that's why I thought it was weird I got a hit last night. Btw, it looks like my 2 pm hit is skipping for a second day.
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Chad

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Re: Imitrex Question
Reply #16 - Oct 8^th, 2009 at 2:52pm

Marc,

That's good news. No hit for you today, awesome!!!
I found that when my cycles come to and end it's like a snow storm. It just tapers off with a hit here and there till if finally stops. However, my last hit that I had last week was a dandy, but it just shut off like that and hasn't returned since. I actually went to work last week w/o trex injections thinking the beast left, but on Thursday I thought I had sinus pressure due to this weather and bam! I left work, drove home and guess what? The beast left me as soon as I got home. So, I turned around again and went back to work with trex this time.

What did I learn, never leave home w/o your weapons even when you think you're out of cycle.

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When the PAIN starts, I FIGHT back!

Rivea Corymbosa seeds were my KO punch, now D3 is the front runner!

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slhaas

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Re: Imitrex Question
Reply #17 - Oct 12^th, 2009 at 8:00pm

I successfully used this method for months in the past, but there are associated issues. First, it is really expensive to take 1 or 2 imitrex pills every day. Second, I started getting rebound headaches after taking it regularly for so long. The pills act too slow to be an effective abortive, but I keep them around for situations where they are more convenient. I also take one before bed when I am in a cycle and absolutely must sleep through at least most of the night. I've also discovered that they help a lot with a hangover, for whatever that is worth.

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