Cluster headaches?

Hello,

Fioriciet (acetaminophen) is a pain reliever and fever reducer.

Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache.

Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow.

The combination of acetaminophen, butalbital, and caffeine is used to treat tension headaches that are caused by muscle contractions.

Cluster headaches

Over-the-counter pain medications (such as aspirin, paracetamol, and ibuprofen) typically have no effect on the pain from a cluster headache. Unlike other headaches such as migraines and tension headaches, cluster headaches do not respond to biofeedback.

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Medications to treat cluster headaches are classified as either abortives or prophylactics (preventatives). In addition, short-term transitional medications (such as steroids) may be used while prophylactic treatment is instituted and adjusted. With abortive treatments often only decreasing the duration of the headache and preventing it from reaching its peak rather than eliminating it entirely, preventive treatment is always indicated for cluster headaches, to be started at the first sign of a new cluster cycle.

Abortives
The TCAs include the following agents which are predominantly serotonin and/or norepinephrine reuptake inhibitors:
Amitriptyline (Elavil, Tryptizol, Laroxyl)
Amitriptylinoxide (Amioxid, Ambivalon, Equilibrin)
Butriptyline (Evadyne)
Clomipramine (Anafranil)
Demexiptiline (Deparon, Tinoran)
Desipramine (Norpramin, Pertofrane)
Dibenzepin (Noveril, Victoril)
Dimetacrine (Istonil, Istonyl, Miroistonil)
Dosulepin/Dothiepin (Prothiaden)
Doxepin (Adapin, Sinequan)
Imipramine (Tofranil, Janimine, Praminil)
Imipraminoxide (Imiprex, Elepsin)
Lofepramine (Lomont, Gamanil)
Melitracen (Deanxit, Dixeran, Melixeran, Trausabun)
Metapramine (Timaxel)
Nitroxazepine (Sintamil)
Nortriptyline (Pamelor, Aventyl)
Noxiptiline (Agedal, Elronon, Nogedal)
Pipofezine (Azafen/Azaphen)
Propizepine (Depressin, Vagran)
Protriptyline (Vivactil)
Quinupramine (Kevopril, Kinupril, Adeprim, Quinuprine)
As well as the following atypical compounds:
Amineptine (Survector, Maneon, Directim) - Norepinephrine-dopamine reuptake inhibitor
Iprindole (Prondol, Galatur, Tetran) - 5-HT2 receptor antagonist
Opipramol (Insidon, Pramolan, Ensidon, Oprimol, Seroquel ) - σ receptor agonist
Tianeptine (Stablon, Coaxil, Tatinol) - Selective serotonin reuptake enhancer
Trimipramine (Surmontil) - 5-HT2 receptor antagonist

Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. In general terms, prophylactic measures are divided between primary prophylaxis (to prevent the development of a disease) and secondary prophylaxis (whereby the disease has already developed and the patient is protected against worsening of this process).

Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches.
Triptans
Sumatriptan and zolmitriptan have both been shown to improve symptoms during an attack.

Other
Some non-narcotic treatments that have shown mixed levels of success are botox injections along the occipital nerve, as well as sarapin (pitcher plant extract) injections.
Lidocaine and other topical anesthetics sprayed into the nasal cavity may relieve or stop the pain, normally in a few minutes, but long term use is not suggested due to the side effects and possible damage to the nasal cavities.

Narcotic

It originally referred to any substance that relieved pain, dulled the senses, or induced sleep. Now, the term is used in a number of ways. Some people define narcotics as substances that bind at opiate receptors (cellular membrane proteins activated by substances like heroin or morphine) while others refer to any illicit substance as a narcotic. From a legal perspective, narcotic refers to opium, opium derivatives, and their semi-synthetic substitutes.Though in U.S. law, due to its numbing properties, cocaine is also considered a narcotic

Take care

road2glory was right on. It is no secret that the single most effective, safe, and reliable abortive treatment of cluster headaches (as a CH is just beginning) is oxygen. Best estimates are that over 80% of sufferers can abort an oncoming CH within 30 seconds to 15 minutes when O2 is administered at 8-15 liters/minute using an appropriate mask. [Standard hospital masks or cannulas dilute the O2 too much to be consistently effective.] Though not 100% safe for everyone, pure oxygen is far safer than any other effective CH treatment.

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As a long-time CH sufferer who discovered the oxygen treatment over 10 years ago at www.clusterheadaches.com, I disagree that drug companies are conspiring to keep this treatment from sufferers [at least not directly... :-) ]. Because CH is relatively rare, even many neurologists have little experience treating CH and are not familiar with the research and clinical evidence for treating CH with oxygen. Also O2 does not seem to prevent a CH, it seems only to abort a single headache at onset. For those who may have 4-10 (or more) CHs every day during a cycle, it means the sufferer who relies only on O2--by necessity or choice--needs to have several portable O2 tanks and a larger at-home tank available at all times. As a result, many CH sufferers need to take other medications as well.

Which brings us back to Fioricet. None of the ingredients in Fioricet--nor the combination--is known to be useful in the treatment of CH. Only caffeine has been anecdotally helpful in lessening a CH, though use of caffeine is also believed to result in rebound CHs and--as a vasodilator--may also exacerbate CHs, which are associated with vasodilation of blood vessels around nerves in the head. However, even those who find a good cup of Joe in the morning helps ward off morning CHs (before the rebound headaches hit later) would likely find the amount of caffeine in Fioricet to be pretty useless.

tammi0119, I trust that you asked this question out of curiosity and that neither you or a loved one was prescribed Fioricet by a physician to treat CH. However, on the chance that it was, find a neurologist who specializes in headaches, preferably one with experience treating cluster headaches. As many "clusterheads" have learned the hard way, don't assume a headache specialist will be aware of wide variety of treatments for CH, which ones are the safest and most effective, and the experience to know which ones are likely to work best if the first-line treatments don't work. [Did I mention that other than O2, there are many different treatments that work well for some people, but few that work for a majority?]

Good luck tammi0119. Wishing you or your loved one many pain-free days. If Fioricet seems to contribute to that goal, great. But there is no evidence to believe that it would.