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gardengal
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how much pain is expected when on med
« on: Feb 26th, 2006, 12:07am »
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I have been on verapamil for 5 weeks now. I usually feel OK during day,just some pain in temple sometimes,but every night I have migrane level pain. I usually freak and take a relpax,but don't want to if I don't really need it. It hurts just enough to keep me up. I have upped my Ver. to 420mg 2 days ago. Should I be totally pain free? I used to just suffer and take nothing and the cycle would be over in 2-3 weeks.
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MJ
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Re: how much pain is expected when on med
« Reply #1 on: Feb 26th, 2006, 12:28am »
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on Feb 26th, 2006, 12:07am, gardengal wrote:
I used to just suffer and take nothing and the cycle would be over in 2-3 weeks.

 
Hey Garden gal
 
Might be something to be said for med free in your case.
 
 How many years were you just suffering before you started the meds? Have your cycles changed since starting meds?
 
I'm one of those cases who never found a traditional med that helped me. Most like verapamil and others made things worse for me. Without the meds I allways had cleaner CH with all the pain but I knew a cycle would end.
 
I know a lot here will be able to answer the verapamil question as it seems to work for many.
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Re: how much pain is expected when on med
« Reply #2 on: Feb 26th, 2006, 12:51am »
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I had 1 or 2 bouts a year from age 17 to 34 then pain free for 8 yrs.(I had almost forgot how horrible they are) now they are back. I tried meds off and on but nothing seemed to help in the past. I tried to tuff it out for 3 weeks then got on the verapamil this cycle. I haven't had a full blown CH but I still have almost constant headaches. It just wears you down so much.
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Re: how much pain is expected when on med
« Reply #3 on: Feb 26th, 2006, 12:55am »
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I forgot to add, the reason I started the meds this time is because I had one while at work( unusual during the day) and it was terrible explaining myself and waiting for my husband (who had to leave work)to get me, I couldn't drive. I was so afraid that would happen again I was desperate so am trying meds.
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Re: how much pain is expected when on med
« Reply #4 on: Feb 26th, 2006, 8:12am »
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I am still on meds. even though I'm currently in a rare remission period (over one month now) in what has been a chronic condition.  I take a combination of Lithium 1200mg, Verapamil 720mg & Melatonin 9mg.
 
I'm not sure if you're describing the pain of a headache in between Ch attacks in your post or the pain of CH attacks so I'll jus explain how preventatives like  Verapamil have worked for me.
 
First, I am pain free between attacks.  When my meds. are taken on schedule, I still have CH attacks but they are less frequent and less severe (one or two per night lasting 20 min. to an hour hour, under Kip7).  Throw in a day or two each week where no attacks occur.  I still  may experience 4 - 5 attacks in a night, some of them severe and long but with the meds. - taken of a good schedule, nights like these are rare.  
 
If I forget a dose or take it late by 2 hours or more - It will be a bad night - guaranteed 4 to 5 attacks that go off the Kip scale and can last for hours.  Even a small screw up in my schedule and it can take a week or more to get back to nights of one or two attacks and I can forget about attacks skipping a night or two.
 
Verapamil is not a pain killer if that is what you are expecting.  It works to reduce/eliminate CH attacks and/or decrease the severity of attacks when they occur.  Building/maintaining blood serum levels are important for meds. like these to be most effective.
 
Tom    
 
 
 
 
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Re: how much pain is expected when on med
« Reply #5 on: Feb 26th, 2006, 9:29am »
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Following up on Tom: very important to stay on Verap for months at a time if that what works for you. Dosing changes do not show the effect quickly--need to give several day before you make a judgment about effect.
------------------
: Headache. 2004 Nov;44(10):1013-8.    
 
    Individualizing treatment with verapamil for cluster headache patients.  
 
    Blau JN, Engel HO.  
 
    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-101Cool.
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Re: how much pain is expected when on med
« Reply #6 on: Feb 26th, 2006, 10:30am »
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Something to consider is, what worked before (seems like at least for me) will eventually fail and stop working.  Oxygen quit working after 2 years,  Lithium quit working after 2 years, indocin quit working after 5 months.  So I would say it has either quit working for you or you need a higher dose.  Good luck finding something.
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Re: how much pain is expected when on med
« Reply #7 on: Feb 26th, 2006, 10:40am »
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Hi!
 
Sorry to hear about your hit at work I too know what that is like.  I dont think that there is one of us who is pain free.  For me Verapamil seems to help keep the number of my attacks down not the severity.  So we do what we have too when we are attacked to take the pain down if not gone at least to a level you can deal with.
 
MYNM156
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Re: how much pain is expected when on med
« Reply #8 on: Feb 26th, 2006, 12:13pm »
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There is no known preventative that will completely eliminate thye attacks. Verapamil will will reduce frequency and intensity. Sounds like its working for you.
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