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

Suggest you print out this material and discuss options with your doc.
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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!)
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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]

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

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?

I have great results with Zomig nasal spray, they also give you six.  Also found it was less impactful to me side effects-wise. 
.
Re trex injects, they are great.  I had been given the auto injector, but I found out I could also get "single dose vials" - which are just little vials that you use a very small insulin syringe to dose out.  I could get three uses out of one vial.  The insurance company (depending on which co.) would pay for 2 vials or 5--  if you can get those it's easier than trying to play with the auto injector.

They look like this:

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

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!

ttnolan wrote on Oct 14^th, 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

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 10^th, 2009 at 7:12pm:


retrovertigo wrote on Mar 10^th, 2009 at 7:41pm:


retrovertigo wrote on Mar 14^th, 2009 at 9:52am:


retrovertigo wrote on Mar 14^th, 2009 at 7:06pm:


retrovertigo wrote on Oct 7^th, 2010 at 8:17am:


retrovertigo wrote on Oct 7^th, 2010 at 6:31pm:


retrovertigo wrote on Jul 16^th, 2012 at 9:09pm:


retrovertigo wrote on Jul 17^th, 2012 at 6:01am:


retrovertigo wrote on Jul 21^st, 2012 at 3:12pm:


retrovertigo wrote on Oct 10^th, 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?

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. 

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