Reccuring headache from triptan...

I found an interesting info that explain why would some HA bounce from a triptan:

When do triptans kick in - and for how long?
The triptan that stays in the body for the longest period is also the one that best prevents the migraine from coming back; patients taking triptans excreted from the body faster experience that the migraine comes back more often.

http://www.migraine.ie/index.php?id=317


well, that would explain why some people experience "rebound". It could be not a rebound, in fact,
but simply the headache itself goes on.


Risa

Interesting article Risa. Thanks for the link...

I take Frova.
With the longest half life of all by far.It works in between 2 and 5 hours. Usually the former.
Unless I go to bed my migraine almost never comes back.
But I can sleep it on again....

So if I wake with a migraine and take a Triptan say 8am.
I wont have the pain return that day.
So I sleep at night and I can wake up the next morning and need another.
OR: I wake okay, but need another the following morning.
This can go on over 5 days, or 3, or it can just be the one day.

I figure migraine can last 72 hours they tell us, so the Frova kicks it.
But for me sleeping(at night) seems to be a trigger, so the migraine comes back.
This is not rebound, it is the same damn migraine....

I talked to my neuro about this, and he agreed.
I have a long migraine run of average 3 days.

But then I can go 5/6/7/8 days before I need another Triptan.
This is what would be odd if it was a rebound.
HOW, does the drug decided when to rebound....????
HOW does it chose to do it over 3 or even 5 days??
But then just stop. Why wouldnt it continue....
He agreed, that is because it is not rebound, it is migraine.

I think it is about time they stopped tagging all of us with rebound,
and just consider that some of us just have a lot of pain.....
The drugs help. It might be the best we can do.
Get relief when we can....
Sometimes I wonder, what they all would do in our positition....just suffer....
I dont think so.....

P

BTW did you see this bit......No wonder we dont always get the right attention or treatment.....

Being completely free of pain was most important for 61% of the patients. The doctors generally did not think that being pain-free was most important (only 31% of them put that criterion on top). 78% of patients thought that a medicine that gave fewer side effects but worked more slowly was better than one that worked rapidly but had more side effects. 90% of the doctors preferred to write a prescription for the slow-working medicine with few side effects. 68% of the doctors would rather prescribe the cheapest medicine if there were a choice between two types with the same side effects, but only 25% of the patients thought that the price was important.

Yeah, what the doctors think and what we, the patients think is so off, looks like. geez.
Talk about different interests.

About when it's still the same headache and when it's a rebound - it is sometimes really really hard to distinguish,
if possible at all.
I would suppose if you have all or at least SOME other M accompanying symptoms you can assume it is still
an ongoing, same episode.



Risa

That link is excellent. lt has a good summary of a lot of recent research. Thanks for posting it!

I particularly was intrigued with the following

Allodynia? Take your triptans early
It has now been found that migraineurs with allodynia (increased sensitivity of the skin) often don´t get an effect from their triptans if they take their medicine a couple of hours into the attack.

A study in Boston showed that treatment with triptans worked in 93% of 27 attacks that were not followed by allodynia, but only in 15% of 34 attacks that were followed by allodynia.

[/quote]

I'm not sure who else here has that problem. I definitely am very hypersensitive to touch and vestibular motion when I have a migraine. It's as if every nerve cell on by body is on high alert.

I am, too! I am generally hyper sensitive to touch any time.
Touch me with a feather, and I will jump a foot up in the air!

Risa

See I dont get it, and I think this confirms that suggestion of timing maybe?
I can take a Migard hours after the pain starts and it works.
It works in pretty much the same time regardless.

The only thing that affects the efficacy of them is if I take one early morning.
If I then fall back to sleep, it is almost as if I have only taken it from when I wake properly.
So if I take one at 7am and doze until 9. Might as well have taken it at 9....
Sleeping and I just dont seem to get along....

P

I think I'm a cross. I'm another one who is super sensitive (thankfully the light component seems to have vanished) and my triptan only works well if I take it almost upon waking. And it only lasts that day. Mine go for 3 days (at least) so I don't know if sleep messes with it or if they just don't fully knock it out...

Becky for me, I am sure sleep messes with it.
As you know 90% of my migraines come in the night.
And even with the Triptan I do think that if I could stay awake,
I probably wouldnt have to take another the next day or day after...

I dont know what sleep does to me but it aint good....

I didn't realize there was a name for it...allydonia...hmmm.

I don't always get it, but sometimes I can't stand the weight of a necklace on my neck....the sheets and blankets are too heavy. The thought of a back rub to help relax me? NO WAY.