Posted by gary (208.133.221.144) on December 08, 1999 at 18:13:20:
been reading a lot about rebounds
seems that as a GENERALITY this isn't a problem with CH
EXCEPT where Imitrex is involved
then we see many folks saying they believe they are getting extra (rebound) attacks because of so much imitrex
this may be the case-
we see the "Imitrex Tip" info on CH.com that suggests 1/3 to 1/2 the migraine dose is adequate for CH, it may be that those who are using the "full"dose, as labelled for migraine, but for CH, and frequently MAY INDEED be creating a high tolerance to the Imitrex which raises the CH threshold to where they come on rat-a-tat-tat, much more freqeuntly than the patient has previously experienced -
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also:
Ueli made an EXCELLENT point, that the "rebounders" may be nothing more than a case of the dose wearing off before the underlying "trigger" releases - - in which case it isn't some mysterious effect - just the med effect didn't last as long as the attack
I used to have that happen with percoset - which has a very short effective period in my case
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on the other hand, I have had MANY spells over the years where I get lengthy periods of 10 or 12 attacks a day, and it has been under different types of therapy, and know from my own experience in at least 50 or 60 clusters over the years, that it is VERY VERY VERY difficult to accurately predict attack patterns
beyond a loose generality
this makes it VERY difficult to be positive about "why" one attack follows another in short order
rebound headache DOES make sense in other situations where people take pain meds heavily, for a lengthy period, then stop-
but I believe that's nothing more than plain oldfashioned "withdrawal" pain
except they've got a new "politically correct" name for it
because withdrawal implies addiction, which many people are offended by
plus, it gives another topic than can feed lucrative magazine articles, etc