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Generic Imitrex (Sumatriptan) Tablets & Injections Available in US

piggy bankTablet and injection versions of generic Imitrex (sumatriptan) are available in the US. Doses are 25mg, 50 mg, and 100mg tablets and 4mg and 6mg injections (kits or pre-filled syringes). Patients have reported prices between $35 and $200! Imitrex’s patent doesn’t actually expire until February; a reader suggested it might be less expensive then.

The generic hasn’t been as effective as the brand name drug for some patients. In Generic Imitrex (Sumatriptan) — Is it as Effective as Brand Name Imitrex, blogger Doc Shazam writes:

…I have taken 2 of “Dr. Reddy’s” generic sumatriptan tablets with almost no relief of headache symptoms, but a plethora of side effects, including aching muscles, nausea, “light headed” feeling and general dis-ease.

Read about other patients’ experiences in their comments on earlier posts on The Daily Headache:

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LSD’s Therapeutic Uses to be Studied in Medical Trials

Albert HofmannAlbert Hofmann, the chemist who discovered LSD, died last week, but not before seeing his “problem child” return to it’s use as a medical treatment. Originally celebrated as a potential treatment for psychosis, mania and depression, the drug’s therapeutic uses were studied widely in the 40s and 50s. Then came the 1960s. Not long after the counterculture embraced LSD, toxic knockoffs hit the streets. LSD’s therapeutic benefits were lost in the chaos.

Having “spent the latter part of his life consulting with scientists around the world who wanted to bring his ‘problem child,’ as he called the drug, back into the lab to study as a therapeutic agent,” Hofmann was rewarded with news that Switzerland health officials approved the first medical trial of LSD in more than 35 years. The trial will test if the drug can ease end-of-life distress. Several more trials are in the works:

“I think people in this country, when they see a patient in pain, will not deny that person a medication just because the drug has abuse potential,” said Dr. John Halpern, a Harvard psychiatrist who is testing the effect of MDMA-assisted psychotherapy in late-stage cancer patients. “LSD is always going to be a touchy subject but I think it’s kind of fallen back to earth.”

LSD is a potential treatment for headache disorders, particularly cluster headaches. With a similar chemical structure to serotonin, LSD has possibilites for other headache types as well.

Photo by Philip H. Bailey

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A Visit to My Headache Specialist: Migranal, Seroquel, Biofeedback & Headache Management

Another visit to my headache specialist, another round of medications and therapies. This is the first time I don’t have any anticipatory excitement that one (or some) will help. It’s not that I don’t think there’s a chance, I’m just too tired to get caught up in what ifs.

The prescriptions I left with are for Migranal, an abortive, and Seroquel, a preventive. I’ve never tried Migranal as on-the-spot abortive. I did use it when a three-week intensive treatment of injectable DHE caused muscle pain. (DHE and Migranal are essentially the same drug, just in different delivery forms.) That three-week treatment was cut short after I failed to respond even the tiniest bit.

Seroquel has been on my mind since reading this success story. I know what works for one person doesn’t always work for another, but I needed to ask. Since I’ve tried multiple meds in all the classes of drugs used for headache with no success, my doctor and I decided it was worth a shot. It can be sedating, but I have to wonder if being sedated with less headache would be better than the exhaustion that accompanies a migraine. (I need to read the full side effect profile before I fill the prescription.)

Biofeedback and headache management therapy are the other two treatments I’m going to try. That’s right, I have never tried biofeedback. I feel like an impostor writing a headache blog without trying it. I’ll be able to shed my shame soon.

Even though I don’t really know what it is, headache management is what I’m most excited about. Apparently I will learn tricks to help when I have a bad headache, like massage and neck exercises.

As I write this, my head is bad so my outlook is bleak. Whenever I have a low migraine, low pain, high energy stretch, like I did last week, I return to “normal” with a thud. Having had a total of three good weeks in the last two months, I now believe I’ll have more migraine-light days in the future. But I quickly grow impatient for the next time to arrive.

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Prescriptions More Common Than Explanations

I always tell you to talk to your doctor before taking any medications or supplements or latching on to a diagnosis. As well-intentioned as these pronouncements are, I sometimes feel like I’m doing the same CYA that drug companies do in ads. Really it’s that I want you to be safe and hope that a doctor’s input may help.

I know even that may be a long shot, a belief backed up by a recent study. The findings indicate that many doctors prescribe medication without explanation of the drug’s purpose and side effects or even it’s name. According to the New York Times article on the study:

“Although there were variations, depending on the type of medicine
prescribed, 74 percent of the doctors mentioned the trade or generic
name of the medicine, and 87 percent stated its purpose. Sixty-six
percent said nothing about how long to take the medicine, 45 percent
did not say what dosage to take and 42 percent failed to mention the
timing or frequency of doses. Physicians mentioned adverse side effects
only 35 percent of the time.”

So you can’t always rely on your doctors for information on drugs, is there anyone who can help?

Check with your pharmacist. They are trained to know drugs inside and out. Many enter the field with a goal of helping people, but the reality of the job doesn’t involve much of that. Most pharmacists I’ve met are more than happy to explain medications — even if they are over-the-counter — and answer questions. If the pharmacist at your local Walgreens is a dud, try the Walgreens that’s two blocks down the street!

Talk to a friendly person in your doctor’s office. Maybe you get along great with the nurse who takes your blood pressure; it can’t hurt to ask for clarification that you don’t get from the doctor. In some offices, a physician’s assistant or nurse practitioner returns phone calls for the doctor. You may find that they have more satisfactory answers to your questions. If you get along well with the PA or NP, why not consider making your next appointment with him or her? Or if you’ve always seen the head honcho of the practice, you might consider seeing some other doctors in the practice. They may be less harried and, thus, have a more patient-friendly demeanor.

A naturopathic doctor is another option. By focusing on the person instead of the patient, much of the appointment is about addressing the person’s questions and concerns. Licensed NDs are trained to integrate their treatments with those of western medicine — understanding pharmalogical treatments is a vital component of this practice.

Last but not least, ask your doctor! Yes, it seems like the job should require such explanations, but it’s also a high pressure job. Haven’t you ever forgotten to explain things to your co-workers, employees or clients? Being a recipient of information is as big of a job as being the giver of that information. You aren’t a passive recipient. You’ve got to ask your questions to have them answered. Of course, if your doctor consistently comes up short, it’s probably time to look for a new doc.