Imigran overdose?

05 Feb, 2012 - 12:33 am

Hi everyone,

My partner of 2 years has been having severe headaches for the last two weeks. First, she had one attack a day, but the attacks have now become more frequent and today she had three within 24 hours.
I have done some research and I think based on her symptons (attacks are unanounced, she can't lie down, is crying, screaming, knocking her head, etc.) she is suffering from CH.
Before this episode, she has been telling me about her migraine situation and that she has been having a severe migraine period every 2-3 years since 2001. Between those periods she is having regular headaches which are "manageable" with Nurafen. She has tried various medication, she saw a neurologist, various GPs with no success.
When this latest episode started 2 weeks ago, she tried various medication her GP prescribed with very limited success. I then suggested to her to ask her GP to prescribe her Imigran, which I friend of mine brought to my attention. And Imigran has seemed to be effective (at least to some extent). She is now taking a 10mg tablet as soon as she feels the attack is coming, and usually her pain becomes "manageable" ca. 15 mins after the start of the attack. Now, her GP is reluctant to prescribe her more tablets because of risk of side effects, etc, considering she has been taking already around 20 tablets over the last two weeks with three alone in the last 24 hours. I'm also concerned about this strong medication but cannot see an alternative at this stage.
The questions I have (at this stage) are as follows:
1. In the short term, what alternative to Imigran is there for her to be able "manage" her severe pain. Is there an issue for her to keep taking Imigran until this episode is over?
2. Is it worth taking her to a hospital and have her under constant supervision by doctors, and if so which hospital in/around Melbourne is recommended?

Any advice would be appreciated.

Thank you
Al

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05 Feb, 2012 - 4:36 am

G'day Al,
very sorry to hear your partner is suffering, we'll do what we can to help.

First, are you sure it's Imigran (sumatriptan) she's taking? It was my understanding the tablets only came in 50 and 100mg form. Or is there an "0" missing from your post? It's absolutely essential this information is correct. 300mg of Imigran is considered the maximum for any given 24 hour period.

You really need to get an accurate diagnosis, Al. There are many different types of headache, and some of them mimic CH quite closely. After a proper diagnosis, she can begin managing her condition. CH is not cureable, but remission is possible.

Have a sift through the information down the left hand side, there's a heap of good stuff there. Standard treatments, non-drug treatments, Oxygen therapy etc.

The "practitioners" heading lists Doctors who are familiar with CH, and yes, there's not many of them, although the list is by no means complete.
As a guide to help your GP/ neurologist, keep a record of attacks; length, strength, medication taken, food or drink consumed that might have caused the attack, as well as the time of the attack. The more information you can provide, the better your doctor can decide what to do.
Also of vital importance is to keep a record of what medications are prescribed, and to check up on them yourself. Some drugs have different names but the same ingredient, making overdose a possibility.
Good luck to you and your partner, do ask any questions you have, we'll answer the best we can. But do get an accurate diagnosis as soon as you can, ok?
cheers peter.

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05 Feb, 2012 - 9:28 am

Peter,

Thanks for your reply.
My mistake, it's 100mg no 10mg Imigran tablets she is taking. So it appears that she has reached the maximum daily dose.
I totally agree with you that we should get an accurate diagnosis. The problem we have been facing is that GP's simply did not come across as having a good understanding of migraines/CH, different treatment options, etc. I'm planning to make an appointment with one of the practioners listed on this website.
The information provided on this website has been very valuable and I really appreciate your advice.

Thanks,
Al

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05 Feb, 2012 - 10:47 am

Hi Al,
you'll find out very fast that most doctors simply aren't aware of CH, which is really not surprising as it's extremely rare. Hence the need to read up as much as possible. You never know; upon diagnosis it could turn out to be something else. There's one type of headache, similar to CH but only found in females that is completely cureable. Try an get an appointment with a neurologist (easier said than done I know); they will generally order MRI scans to rule out anything else causing the attacks.
Re: Imigran; maybe try the pills at 50mg. That way If your partner finds she's having more than 3 attacks in a day (not uncommon), she still will be within the accepted limits. Personally, I find the 50mg works fine, but that's for you to find out.
Other things you can try: avoid processed foods, especially those containing nitrates (salami, sausages, deli meats in general) avoid fast food, drink LOTS of water, but do maintain vitamins and minerals.

It's a lot to take in, but remaining positive is also really important, for both of you.
Good luck,
Peter.

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05 Feb, 2012 - 11:12 am

Hi Al,

firstly, I looked at some of the practitioners listed here recently and got the impression that some of them were no longer practicing at the specified locations. I can't remember the specifics now but there were two professors listed, one at Monash and one at the Alfred, but google gave me the impression they may no longer be at those hospitals. I did get a number of hits relating to CH at St Vincents Hospital or possible private neurologists located nearby that hospital. If you find someone good let me because I am hunting around myself for a definitive diagnosis from a specialist.

As far as treatment goes oxygen has a proven track record both anecdotally and according to validated research. It carries no side effects when used in regard to CH and can be used many times a day if need be. It may not work for 100% of people but there is only one way to find out if it is suitable for your partner. The only stumbling point may be your doctor if they are not familiar with CH and the use of oxygen in that setting. You would need a high flow oxygen setup quite unlike the home oxygen devices most GPs would prescribe for patients with airways diseases.

Also worth trying some Red Bull or similar energy drinks containing caffeine and taurine. It seems many CH sufferers find significant benefit, but I don't know that there has been any reliable research one on this (?).

I am a beginner in this field so I am sure there will be many veterans on this forum who can advise you further on these matters. Good luck.

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05 Feb, 2012 - 3:21 pm

Hi Al,

Sorry to hear about your partner, firstly you must get the correct diagnosis. If you can find a GP that has some knowlage about CH try and get them to refer you to a Neurologist or a Pian maqnagement Clinic at your local hospital. There are many forms of preventative medications available, if you can get sorted on the preventative front then the next step will be to get some abortative medication under way. If you do go the way of the O2 then you need to get a letter from your GP stating that you need it for Clusterheadaches and that you require a flow rate of 15 L/Per Min to be effective

Make sure you take some of the information with you, i know that there is alot of info on the site but if you print out the important stuff and take it with you to the GP.

I hope that you get some sort of diagnosis as soon as possible so that you know were to go next with the treatment side of things.

Matt
Silent Planet

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