Triptans - Everyone please read!

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Annuk
Veteran Member


Date Joined Jan 2006
Total Posts : 1308
   Posted 3/21/2008 11:27 AM (GMT -6)   
Hi guys,

Just thought it would be worth putting up a post about the triptans just to ensure everyone is aware of the pros and cons.

For many these drugs are a brilliant abortive but as with some other drugs they can cause rebound headaches if taken too frequently in some cases. This seems to be peculiar to migraineurs as Clusterheadache sufferers can take them every day without the rebound effect!

Also just a reminder that any triptan (there is no exception) cannot be taken more than twice in any 24 hours because of its effect on the heart, irrespective of the dose.

take care

Ann
Co-Moderator of the Migraine/Headache Forum


korbnep
Regular Member


Date Joined May 2007
Total Posts : 327
   Posted 3/22/2008 6:24 PM (GMT -6)   
Thanks for the post Ann, a very important topic indeed. Just two things I wanted to mention:

1) I'm not especially knowledgeable concerning Cluster Headache sufferers, but why is it that they are less prone to rebound? I have never heard of this, though I am no expert.

Also, I think that there are reasons that triptans are only supposed to be taken 2-3 times a week max aside from rebound risks. All of the detailed prescribing information that I've read about many triptans has stated this type of limit without noting any kind of exception (other than by express doctor's orders, but I think that they would only order more frequent use for a very short term acute treatment).

2) It's definitely important to not take more than 2 doses/24 hours (unless your doctor says otherwise). One thing that I didn't initially know, however, is that it's also unsafe to use any ergotamine derivatives (like Cafergot and DHE) during the same day as a triptan. This is also due to the potential cardiovascular risk.
DX: NDPH, Recovered CRPS
RX: Lamictal, Provigil, Clonazepam, Ambien CR, Emsam, Namenda, Oxycontin, Oxycodone
PRN: Haloperidol, Zyprexa, Lodine, Zofran, Skelaxin


Annuk
Veteran Member


Date Joined Jan 2006
Total Posts : 1308
   Posted 3/23/2008 2:28 AM (GMT -6)   
Hi Ben,

Unfortunately Ben I cannot give an answer to your first question. I work on the helpline for OUCH UK (there is a link on this site somewhere), which is a registered charity for the support of Cluster Headache sufferers. OUCH stands for Organisation for the Understanding of Cluster Headache. I do know many chronic sufferers of CH that take the Imitrex injections twice per day and have done so for some years without rebound.

You make a very good point in your second paragraph about the use of DHE or any ergot based drugs. Ergotamine is the forerunner of the triptans and acts on the blood vessels in much the same way but has more side effects than the triptans. Therefore any Ergot based drug and a Triptan MUST not be taken within 24 hours of each other.

As always guys, please, please check with you Doctor about any of this and before you change any drug regime. I am not a Doctor etc!

From what I have learned over the years, my understanding is that migraineurs are particularly prone to rebound headaches if any abortive is taken more than twice per week. I suffered with rebounds for years and I would not recommend it!!! The rebounds masked the symptoms of what was actually going on for me! It took me a long time to realise this and deal with the rebounds, but with the support of my Doc I got there in the end.

take care

Ann
Co-Moderator of the Migraine/Headache Forum


Brit
New Member


Date Joined Jun 2008
Total Posts : 13
   Posted 6/5/2008 5:31 PM (GMT -6)   
I get horrible chest pains from triptans. My neurologist said that this is good because I know it's working. My opinion is that it sucks and I can't do anything that involves physical activity for days after taking it.
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