Posted by Craig on July 29, 1998 at 12:11:24:
In Reply to: Why do these get DRAMATICALLY worse? posted by Don on July 29, 1998 at 10:15:57:
Since this drug previously worked against your CH,
it sounds as though you were experiencing mild ones.
Drugs like this are usually ineffective... worse
still this contains an analgesic (aspirin) and
those can increase both the frequency and severity
of CHs. They make things much worse!
Sounds like you've inadvertantly gone from a #1 to
a #10 in pain!
The morphine they gave you won't do much against
this type of pain. Optiates are not effective
against head pain; they do stop you minding quite
as much though :)
Stop all the analgesics immediatley, this means all
aspirin, paracetomal and iboprofin. Caffiene can
be effective against CHs because it is a vascular
constricer BUT is also raises your blood pressure
and can therefore cause a rebound headache.
The only abortive medacines likely to be of use
are (Imitrex) and ergotamine based products. These
can have serious side effects though.
You never know how bad a CH is until it's been going
5-10 minutes. The abortive medacines need to be
administered in the first 5 mins to be effective
(eject before the plane hits the ground!) the problem
is that if you start taking them you'll find it hard
to resist doing so for every headache.
Oxygen and cold air are equally effective and both
will successfully abort a CH if taken early enough.
RESIST THE URGE TO HYPERVENTALATE (feels nice but
doesn't work).
There are several preventative medications, these
are usually long acting things such as beta blockers
or methysurgicide. They all take some time to start
working, usually a couple of weeks, so again it's best
to take them at the first warning twinge. Some of
these also have dangerous side effects.
There is one medication I know of that can abort a
cluster, amytriptylene. It is best taken with a
long acting beta blocker such as propranolol, and
both should be taken at night. The beta blocker is
to minimise the side effects of the amytriptylene
and it also acts as a vascular consrtictor.
Amytriptylene is an anti-depressant and takes two
weeks to kick in :(
It may not be worth starting any of these treatments
if your cluster is unlikely to run much longer.
Stop the analgesics though - I promise you the
CHs shouldn't be that bad (I know the same thing
happened to me, thought I was going to burst a
vessel).
Good luck!