My neurologist prescribed Relpax (eliptran) for migraines I’ve been getting as side effects from IVIG treatment for CIDP.
I’ve had a recent attack of TN, and twice now I’ve taken Relpax
for a migraine, and (perhaps coincidentally) both the migraine and the TN subsided. Completely.
I did some Googling, and learned that in a couple of studies a migraine med called Immitrex was very effective in treating TN. Relpax and Immitrex are similar compounds.
I am interested to see if I can continue to battle TN with Relpax. It is possible that if indeed this works, it could be tied to my specific cause behind TN, which could be related to CIDP (an autoimmune disorder).
Has anyone heard of using migraine meds for TN?
Just as a footnote, Relpax is expensive. My insurance company is being billed about $55 USD per pill.
I'm aware that many TN patients also have migraines, and that Imitrex is used as a preventative for the migraines. I've talked with some TN patients who felt that this med helped their facial pain as well, but I haven't seen any consistent pattern. Given that CIPD is a disorder of the myelin, some connection is at least plausible for Relpax.
A pertinent question is why Relpax would be prescribed instead of Imitriex, given the hideously extortionate cost. That's worth talking about with your neurologist. Likewise, you or someone in his office staff may wish to contact the company to see if they have a subsidy program of any kind that could provide this med at much lower or no cost to people who cannot financially afford it.
Go in Peace and Power
Red Lawhern, Ph.D,
Resident Research Analyst, :LWTN
Thanks, Red.
My neurologist says that he is aware of anecdotal information about triptans being effective for TN, but is "strongly recommending" that I try baclofen and/or clonazepam instead.
I also don't know why he specifically prescribed Relpax, although it is working like a charm for my headaches and my insurance company is picking up the vast majority of the expense. The insurance company is taking a few days to approve every prescription - I don't know what he is writing, but they have denied expensive medicines in the past and insisted on cheaper ones. They haven't done this yet with Relpax, however.
The good news is that I haven't had any TN jolts for four days now, so perhaps this recent episode has come to an end. As is typically the case, I have no idea if it is going to come back later today, tomorrow, next month, or next year. And I don't know if this recent episode is on hiatus on its own, or due to the Relpax, or even due to the IVIG infusions I had last week. TN is a bizarre affliction.
The precise mechanism of the triptans is not established. They may serve to produce selective constriction of certain intracranial blood vessels, inhibit neuropeptide release, and reduce transmission in the trigeminal pain pathway.
Since TN may be vascular in nature, similar to migraines, it stands to reason that triptans may be effective. They’re pricey and their use should be limited to less than 9 times per month to avoid rebound headaches, so they’re not a good option as monotherapy for those with frequent attacks. Their blood vessel constricting properties also make them contraindicated for cardiac patients.
I think you meant to say that Imitrex (sumatriptan) is used as acute treatment for migraines. Preventatives are taken everyday, and for migraines those are usually beta blockers, certain antidepressants, or anticonvulsants. Daily use of triptans is actually discouraged because they can lead to medication overuse headaches, which are quite difficult to treat.
Some triptans are preferred over others depending on the patient’s migraine patterns. Imitrex has a higher recurrence rate at 24 hours compared to Relpax. It is still quite pricey.
Richard A. “Red” Lawhern said:
I’m aware that many TN patients also have migraines, and that Imitrex is used as a preventative for the migraines. I’ve talked with some TN patients who felt that this med helped their facial pain as well, but I haven’t seen any consistent pattern. Given that CIPD is a disorder of the myelin, some connection is at least plausible for Relpax.
A pertinent question is why Relpax would be prescribed instead of Imitriex, given the hideously extortionate cost. That’s worth talking about with your neurologist. Likewise, you or someone in his office staff may wish to contact the company to see if they have a subsidy program of any kind that could provide this med at much lower or no cost to people who cannot financially afford it.
Go in Peace and Power
Red Lawhern, Ph.D,
Resident Research Analyst, :LWTN