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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> prednisone?
        
(Message started by: 1968eric on Mar 21^st, 2006, 7:55pm)

Title: prednisone?
Post by 1968eric on Mar 21^st, 2006, 7:55pm

My neurologist and I just spoke on the phone. I told him I had just started another cycle. This one is even worse that previous bouts. He upped my verapamil yet again - now I think is 360. He wrote another prescription for imitrex refills, and this time is going to have me take prednisone for a week.

I haven't heard of this as a treatment for CH? Anyone have some info?

Title: Re: prednisone?
Post by E-Double on Mar 21^st, 2006, 8:26pm

Prednisone is a common treatment used for CH as a transitional medication to be used while your Preventative (verapamil ) is reaching a therapeutic level.
You should find a bit of a reprieve yet once the doses are decreased IF you have not reached a therapeutic level on the prevents.....you will get slammed again.

Good luck!!!

Eric(1973) ;)

Title: Re: prednisone?
Post by maffumatt on Mar 21^st, 2006, 8:26pm

Check out the medical info link at your upper left under the yellow new visitors link.
Prednisone

For the episodic form of cluster headache, prednisone is highly effective in over 75 percent of patients (Kudrow, 1978) (Table 6-3). The value of prednisone has been established in a double-blind study (Jammes, 1975), and it is clearly a first-line drug, if not the drug of choice in this situation. The dosage has varied from 10 to 80 mg daily in various studies (Couch and Ziegler, 1978). I use 80 mg per day for 7 days and then rapidly taper the dosage over 6 days. Pain paroxysms usually cease within hours for the first dose. If there is no response after 48 hours, prednisone should be stopped and an alternative therapy instituted. If, while the dosage is being tapered, headaches return, prednisone may need to be continued for the duration of the cycle, preferably on an every other day basis, at dosages less than 140 mg weekly. Many patients have to take prednisone for 5 or 6 days, but then stop it and find that the bout is over. This has happened often enough to convince me that prednisone can actually terminate the bout for about 20 percent of patients. Watson and Evans (1987) made similar observations in 2 of 11 steroid-treated patients with the chronic form of the disorder. It is, therefore, worth treating the chronic patients with a 2-week course of corticosteroid, with the aim of interrupting the cycle, although in most headaches return when the dosage is tapered.

I have seen several patients who were unresponsive to full dosages of prednisone, but who responded spectacularly to triamcinolone at dosages of 32 mg per day.

The remarkable efficacy of corticosteroids in this syndrome is not easily explained. McEwen et al, (1986) have reviewed the many potent actions of the corticosteroids on the CNS, but these are just beginning to be defined. De Kloet et al (1986) studied the relationship of corticosteroids to the serotonergic projection from the dorsal raphe nucleus to the hippocampus in rat brain; they found that corticosteroids exerted tonic control on serotonergic neurotransmission in this system.

Title: Re: prednisone?
Post by unsolved1 on Mar 21^st, 2006, 9:15pm

My doc wants me to do

60mg X 1 week then
50mg X 1 week then
40mg X 1 week then
30mg X 1 week then
20mg X 1 week then
10 mg X 1 week then stop

I'm gonna BLOW UP like a balloon !! :'(

UNsolved

Title: Re: prednisone?
Post by Guiseppi on Mar 21^st, 2006, 9:41pm

I'm a 200 pound male, episodic, generally two cycles a year. At 30 mg a day, 15 am and 15 pm, I get complete relief from headaches. I use lithium as my primary preventative, but start on the prednisone for a week or so while the lithium levels build up. You do get hungrier then usual and your face might round out a bit. Long term usage has it's problems but as a short term transitional I've used it for 20 plus years and i think I'm still relatively normal!!!

Guiseppi

Title: Re: prednisone?
Post by burnt-toast on Mar 21^st, 2006, 10:42pm

Prednisone is a steroid and has a wide variety of applications. One of then CH. It's generally not a long-term use medication - typically starts with high dosages and tapers off to lower doses to complete a 1 to 2 week taper.

http://www.nlm.nih.gov/medlineplus/druginfo/drug_Pm.html

I avoided it in treatment until the last two years and it may have contributed to going from over 3.5 years chronic into a remission that has now lasted more than 6 weeks.

The first taper showed no positive results, however 2 months after a second taper I started seeing results that eventually led to remission.

Unfortunately I don't have additional personal usage information, but I now have an extra Pred. prescription on-hand. If/when CH returns I'll add the results to my log and keep track.

Tom

Title: Re: prednisone?
Post by NotH20 on Mar 22^nd, 2006, 8:49am

Eric,

I get fantastic results from a round of Prednisone. The only drawback is when I get down to 20mgs per day - I start getting hit. I experienced "fat pockets" this last round and developed a great buldge at the base of my neck - but it went away soon after stopping the medication. Good luck to you - you should probably get relief within the first 24 hours ;;D

Mia

Title: Re: prednisone?
Post by Gator on Mar 22^nd, 2006, 9:29am

on 03/21/06 at 21:15:09, unsolved1 wrote:

My doc wants me to do

60mg X 1 week then
50mg X 1 week then
40mg X 1 week then
30mg X 1 week then
20mg X 1 week then
10 mg X 1 week then stop

I'm gonna BLOW UP like a balloon !! :'(

UNsolved

My neuro has me on this schedule, too. I'm on Day 7 of 20mg. Tomorrow I start Day 1 of 10mg. For some reason this time the pred didn't work as well as it has in the past. I didn't see a totally pf day until day 3 and the hits had started breaking through again by day 7. I've been a bear to live with, short tempered and irritable and have about eaten us out of house and home.

Good luck on the taper, dude.

Title: Re: prednisone?
Post by Jasmyn on Mar 24^th, 2006, 8:28am

Yip, Prednisone, one of those unfortunate meds we sometimes HAVE to use to break a peak cycle.

I actually like to have a remarkably round chest and face, even if it is only for two weeks or four ;)

Title: Re: prednisone?
Post by sandie99 on Mar 24^th, 2006, 1:09pm

Prednisone... I remember that. Made me faint, but did nothing to the pain. I hope that it helps you, though. :)

Best wishes,
Sanna

Title: Re: prednisone?
Post by Richr8 on Mar 25^th, 2006, 1:44am

on 03/21/06 at 21:15:09, unsolved1 wrote:

My doc wants me to do

60mg X 1 week then
50mg X 1 week then
40mg X 1 week then
30mg X 1 week then
20mg X 1 week then
10 mg X 1 week then stop

I'm gonna BLOW UP like a balloon

This is very similar to my schedule. I've been ha free for about six weeks now and it will be another six until I'm at the level of fitness I was before my cycle started. The good news is, I will get back. Shitty way to spend a quarter of your life, but there are sadder tales. :)