Triptans: Not a magic pill

 

 

I wanted to look up the efficiency of triptans because it seemed to me that often, more often than not in fact, I would just get a dulling for a couple hours and then back to full blown migraine. Or it would work for a couple hours and back to full blown migraine.

This isn’t the magic pill we are sold on. The ABORTIVE that will ABORT our migraine 100% so we can continue on with our day. But it can do that. Just not the percentages I had always assumed. The response rate of any kind of pain relief was in the 60%. Completely free of pain at the 2 hour mark were in around averaging 30% and those that sustained it in around the teens, with no adverse reactions. Those that had a migraine again roughly in the 30%s as well.

The thing was I thought the response rate was around 80. With the ones getting 100% in the 60%. And occurrence around 20%. But it shouldn’t have surprised me because Many people have the same experiences as me, so these stats must be quite accurate indeed. Even the failure rate of around 40% seems roughly accurate.

Remembering we can only take these 3 times a week, regardless of how many migraines we get… I myself have been saving them for work days because I work 3 days a week. I have to say dulling my migraine for a few hours… not helping me get through the work day. Just saying. Weel, substantially worse when I worked five days a week and had days not covered at all.

So people have to understand, yes, we have a pill to take for our migraines but it isn’t a magic pill. The responses for every migraine vary. And we are limited in our capacity to take them.

 

 

Source: Treating migraine headaches with Triptans

CGRP #BlogBoost

A friend of mine once said I would feel better if I stopped taking all my medications.

 

Sounds like 2017 will be a good year for migraines. We have the anti-CGRP treatments coming out. Something to look forward to when we have never really had much to look forward to.

Actually, there are more than four companies, developing both monoclonal antibodies that target CGRP or its receptor, as well as other small molecular drugs that target CGRP or other receptors that are widely considered to be important in turning of the pain and other symptoms associated with migraine. These results will become available at the same time that the American Migraine Foundation is launching their national public migraine awareness campaign.   It’s the first time that has ever happened. Dr. Dodick 

The medications target a compound called calcitonin gene-related peptide or CGRP. Researchers have known for some time that CGRP (which is a message carrying chemical) was involved with migraine attacks. But now they are targeting the neurotransmitter itself.

Over half of patients are seeing a 50% reduction in migraine frequency while using the CGRP drugs — some even more.  Dr. Peter Goadsby, director of the UCSF Headache Center in San Francisco, called it “a truly landmark development” that will offer many patients “freedom from the daily grind of being a migraine sufferer.”MigraineAgain

 

It is unique because it is the only preventative designed for migraines to date if it comes out. Every other one is off-label for migraines. This one was specifically targeted to migraines. So far indications are they will reduce frequency and intensity with very little side effects. With Half the patients seeing a 50% reduction. It will be a once a month medication as well which will be a nice perk.

And also how about This For both of the studies that have been fully reported, there are a small proportion of people who, at 3 months, it’s about 15% [whose migraine has disappeared], at 6 months, it’s a little over 10%, where their attacks stopped and didn’t come back.

Here are the two trials:

David Dodick, MD, studied with LY2951742; a humanized monoclonal antibody that binds CGRP. In a phase II he had 218 people with from 4 – 14 episodic migraine headache days per month, and randomly assigned them to get the antibody or a placebo. The medication was given every 2 weeks by injection.

Resulting with a reduction on average of 4.2 migraine days for those on the active drug compared to 3.0 days for those on placebo. 67 CGRP subjects and 47 placebo reported 50% drop in frequency. Mild side effects and self-limiting.

Peter Goadsby, MD r studied with ALD403; a humanized peptide antibody to CGRP.  This one was given intravenously at the start of the trial in an hour long infusion and not repeated.

There were 163 subjects with 82 on the medication and the remainder on the placebo. Average decline in migraines was 5.6 for the medication compared to 4.6 for placebo.

The proportion of patients with 50%, 75%, and 100% reduction in migraine days at week 12 was significantly greater in the ALD403 arm, Goadsby said. MedPage

I am very eager to try out such a promising medication. It is said to be, of course, rather expensive as well, so we will see how that works out. It is hard to say how it will perform, real world. From my experience with Botox, it wasn’t quite as significant as early studies suggested, but nevertheless a boon to those with chronic migraines. This seems to promising, I just don’t want to, well, jinx it.

 

/

There is no Cure #MHAM #CDNmigraine

There is no cure for #clusterheadaches or #Migraine.

There is no cure for migraines. Let’s be upfront about that. Don’t post cure sites. I am tired of it. To be honest treatment for chronic migraines is difficult enough. I am pretty tired of posts about internet and fad treatments that are generally called ‘cures’. I’m sorry but maybe they do work for a migraine but with chronic migraines most actual doctor recommended treatments have failed. I doubt a handful of almonds or Gatorade is going to do the trick. Even together. Even if I made the gross green smoothy with Gatorade and almonds.

You know what I like to do for acute treatment? Triptans. When I can use them, that is what I do. Triptans. Made for acute treatment of migraines. And when I can’t? I use ice and migraine balms and meditation and I suffer. Because that is what people with chronic migraines do a lot of. Suffer. And trying to find ways to make that all right. Trying to find ways to cope with that. And people flashing their ‘cures’ frankly is insulting and ticks us off. If it were so easy. Damn, if it were so easy.
Continue reading “There is no Cure #MHAM #CDNmigraine”

The look you get when you say can’t take NSAIDs

MjAxMi00NjhkZmI0NWE5Y2NjYTdl

The look I get at the ER for anything I go in for when I tell them I cannot take NSAIDs is beginning to get on my nerves. No I am not a crackhead. No I am not a drug-seeker in the sense I am wildly looking to ride the high roller-coaster ride. I AM looking for treatment. And I Happen to have a drug sensitivity to NSAIDs.

The irony of it is I never had this drug sensitivity when I was younger. A doctor gave it to me because she didn’t listen to me. I happened to be off triptans due to the side effects I get and my doctor put me on Toradol pills. They caused nasty cramping pain and diarrhea to the extent I really began to have problems using them at all. So she switched me to Arthrotec. I had less cramping pain and still had diarrhea. So I said I am still having this issue. I think she also thought I was looking for the painkillers… so she said those side effects will diminish. So off I went and kept taking it. Until the blood. I went back and said, yeah, well I think the whole bleeding out my butt is unusual. I was put on a ulcer medication.

I switched doctors as well being as I was ticked she didn’t listen to me. Anyway, after I went off the ulcer medication and was on another NSAID same symptoms. Was taken off of it. Tried OTC same symptoms. Every NSAID, mild, coated, OTC… same symptoms. Even Toradol shots from the ER now caused sharp jabbing pains and diarrhea. Even years later I try OTC Motrin and still the same situation. Regret it every time, just checking to see if the situation is still in ‘effect’

So my new doc said I developed a drug sensitivity. Fine. But go into the ER and say you cannot take NSAIDs and also aspirin by the way… and you get that damn Look. I want to say ‘Hey you guys caused this. It isn’t going to be fun when I get the arthritis coming my way when I am older, runs in my family and I predisposed to. Think I am going to Enjoy the fact I can’t take the one good thing for That? No. So just suck it up and tell me what sort of treatment will help me here.’

It depends on what I am there for but the last few times have been falls from MAV vertigo so I have simply cut them off from saying anything stupid and said ‘Can I recommend a solution?’ And when they say yes. I say, “I can take NSAIDs in cream form if you think that would help in this situation. I just cannot, at all, digest them.”

It calms the dumbasses down a bit.

Frankly, to be honest, I also want to tell them NSAIDs come with side effects which I did experience and caused my sensitivity to them. They are not the perfect damn solution to everything they think it is now.