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Giovanni
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Melatonin
« on: Jun 21st, 2003, 9:02am »
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I wanted to pass on some success recently with the use of Melatonin.  I have episodic cluster headaches and have been in this bout since early March.  Last week I started taking Melatonin about one hour before planned bedtime (Melatonin 3mg+B-6 2mg X 3 tablets from GNC).  I slept soundly for the first time in months without my usual 2:00 A.M. headache.  This relief began on the first night I used this product. I did awaken one time with a shadow that was taken care of by ice.
 
This relief may have been somewhat coincidential in that the cycle might have been tapering/ending anyway, but I do feel the melatonin has had a positive affect.  
 
Anyone else with this result?
 
I wanted to pass this information onto my fellow clusterheads.
 
  ;D Giovanni
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Re: Melatonin
« Reply #1 on: Jun 21st, 2003, 12:45pm »
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I've seen 3-4 medical reports of trials with melatonin, using 10mg at bedtime. Results have been modestly good and worth a personal trial--but not a major break through, it appears.
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Re: Melatonin
« Reply #2 on: Jun 24th, 2003, 5:09pm »
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I've tried Melatonin before with inconclusive results--but not at 10mg.  
 
I'll give it another shot with 10mg this time.
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Re: Melatonin
« Reply #3 on: Jun 25th, 2003, 2:08am »
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Hi-
I've had some luck with Melatonin, but it's difficult for a person who doesn't have a "normal" bedtime.  The whole point, as I understand, is that melatonin will keep your REM sleep deep and constant, and regulate your normal biological "sleep clock".  On weeks when I have a normal schedule, it works about 2/3 of the time.  I took it on top of Verapamil and prednisone, when those two things ceased to work.  My body seems to accomodate itself to the positive effects of drugs pretty quickly, though I wish it would do the same for those nasty side effects!
Koda
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Re: Melatonin
« Reply #4 on: Jun 25th, 2003, 2:54pm »
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I use regularly Melatonin, helps me sleeping when I am in cluster, and also for my heart it is OK!
 
 
Hi Giovanni, my Dad Valentino is near me now and he says you his greetings... ;D ;D
 
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Re: Melatonin
« Reply #5 on: Jun 26th, 2003, 7:55am »
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Well, I went ahead and tried Melatonin again, 6mg the first night and 9mg the 2nd night around 10PM.  
 
Esp. on the 9mg dose, I definitely got really sleepy after about an hour.  However, I also started getting shadows which eventually developed into a moderate attack by midnight.
 
Considering I don't normally get attacks during the night, I'd have to conclude that Melatonin does not help me at all, or may even do more harm than good in my case.
 
 
 
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Re: Melatonin
« Reply #6 on: Jul 1st, 2003, 8:56pm »
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Yes, I have used (and am currently using) Melatonin in my approach to this problem.  I use 5 or 6 mg by 10PM each night.  Seems to make a big difference to me, but does not always work.   Undecided
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Re: Melatonin
« Reply #7 on: Jul 8th, 2003, 8:49pm »
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i dont know if this helps, but my daughters doctor told us to try melatonin to get her to sleep through the night (she has adhd and usually has the energy for about 10 toddlers and shes 6 years old). i guess melatonin is more of a sleep aid and the logic behind it is if you get a good night sleep your clusters will be lessened?? i could be wrong, i dont get my phd untill friday... ----N
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Re: Melatonin
« Reply #8 on: Jul 10th, 2003, 12:38pm »
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Melatonin is a sleeping aid, naturally secreted by the pineal gland.  And it's probably prescribed due to the complaint of not being able to sleep due to the headaches.
 
I know myself, if I don't sleep well, it seems like my headaches worsen... esp during the day.  Then hitting the O2 bottle two or three times a night just makes it worse, I get real worn out.
 
Haven't tried Melatonin, cause sleep usually brings on a h/a at that point.  My next step is a prednisone taper so I can get some rest.  That ALWAYS works.  (until the 20mg taper  Angry)
 
Art
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Re: Melatonin
« Reply #9 on: Jul 10th, 2003, 7:52pm »
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While melatonin may be prescribed as a sleep aid, in clusters there may be more of an effect than just causing drowsiness.  Melatonin is involved in the diurnal cycle with serotonin and other substances in the brain.  As you are aware, some of the medications that are effective against clusters alter serotonin metabolism. The word is still out on mechanism of effect.  Undecided
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A lot more than getting sleep...
« Reply #10 on: Jul 11th, 2003, 3:47am »
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Melatonin versus placebo in the prophylaxis of cluster headache: a double-blind pilot study with parallel groups.
 
Leone M, D'Amico D, Moschiano F, Fraschini F, Bussone G.
 
Centro Cefalee, Istituto Neurologico Carlo Besta, Milan, Italy.
 
A fall in nocturnal plasma melatonin occurs in patients with cluster headache, suggesting that melatonin may play a role in the promotion of attacks. During a cluster period, we administered melatonin to 20 cluster headache patients (2 primary chronic, 18 episodic) in a double-blind placebo-controlled study of oral melatonin 10 mg (n = 10) or placebo (n = 10) for 14 days taken in a single evening dose. Headache frequency was significantly reduced (ANOVA, p < 0.03) and there were strong trends towards reduced analgesic consumption (ANOVA, p < 0.06) in the treatment group. Five of the 10 treated patients were responders whose attack frequency declined 3-5 days after treatment, and they experienced no further attacks until melatonin was discontinued. The chronic cluster patients did not respond. No patient in the placebo group responded. There were no side effects in either group. Although the response rate is low, melatonin may be suitable for cluster headache prophylaxis in some patients, particularly those who cannot tolerate other drugs.
 
Abnormal 24-hour urinary excretory pattern of 6-sulphatoxymelatonin in both phases of cluster headache.
 
Leone M, Lucini V, D'Amico D, Grazzi L, Moschiano F, Fraschini F, Bussone G
 
Neurological Department and Headache Centre, Istituto Nazionale Neurologico C. Besta, Milan, Italy.
 
The typical cyclic occurrence of cluster headache suggests the involvement of hypothalamic rhythm regulating centers in the pathogenesis of this primary headache. In previous studies, reduced 24-h plasma melatonin levels during the cluster period, loss of circadian melatonin secretion in remission, as well as permanently reduced excretion of urinary melatonin in both illness phases have been reported, supporting the hypothesis of a hypothalamic derangement. In this study, the 24-h urinary excretion of the main melatonin metabolite, 6-sulphatoxymelatonin, was evaluated in 20 cluster period cluster headache patients. Thirteen were retested 12 months later, in the same period of the year, during remission. Fourteen age- and sex-matched healthy subjects were the controls. As expected, significantly higher levels of 6-sulphatoxymelatonin were present in nocturnal urine than in day-time urine in controls, while in both cluster headache groups urinary levels of this metabolite did not differ between day and night. Nocturnal levels of 6-sulphatoxymelatonin were significantly lower in both cluster headache groups than controls. Day-time levels did not differ significantly between the groups. Altered excretion of urinary 6-sulphatoxymelatonin even during remission indicates that at least some of these anomalies are independent of the pain, and provides further evidence of involvement of the hypothalamic rhythm regulating centers in cluster headache.
 
Melatonin-responsive headache in delayed sleep phase syndrome: preliminary observations.
 
Nagtegaal JE, Smits MG, Swart AC, Kerkhof GA, van der Meer YG
 
Department of Clinical Pharmacy, Hospital 'de Gelderse Vallei' Ede/Bennekom, The Netherlands.
 
The occurrence of headache and its change after treatment with melatonin 5 mg were studied in 30 patients with delayed sleep phase syndrome. The medication was taken 5 hours before the endogenous nocturnal plasma melatonin concentration had reached 10 pg/mL. Three women (aged 14, 14, and 23 years) suffered from chronic tension-type headache. Their headache disappeared within 2 weeks after the start of treatment with melatonin. One 54-year-old man suffered from disabling migraine attacks without aura, twice a week. After starting melatonin treatment, only three migraine attacks were reported in 12 months. Ever since his 40s, a 60-year-old man complained of cluster headache episodes lasting about 2 months, twice a year. In the year since starting melatonin treatment, only one 5-day cluster episode occurred. Nocturnal melatonin secretion in the patients
with delayed sleep phase syndrome and headache did not differ significantly from that in the patients with the sleep disorder but without headache. Melatonin may be helpful in patients with headache who are suffering from delayed sleep phase syndrome. Its effectiveness may be due to modification of vascular and nociceptive systems or to its chronobiological action which adjusts the patient's biological clock to his/her life-style.
 
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Re: Melatonin
« Reply #11 on: Jul 11th, 2003, 6:29pm »
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I thought I would give an update to my progress since using Melatonin.  No headaches since June 14 with only a few shadows the first week.  Last year the cycle lasted until about July 15.  I feel as though in my case Melatonin has had a positive affect.  
 
I am still dosing about 9mg (+6mg B-6) per night before bedtime.  I had taken the ultimate test last weekend with one drink of Absolute in a martini (shaken not stirred).  
 
It appears, through this message board, as though this medication has different effects with people in helping marginally--to triggering a headache, but in my case it has helped.  Grin
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Re: Melatonin
« Reply #12 on: Oct 26th, 2003, 2:16pm »
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I have been taking melatonin for six weeks:   0.3 mg at bedtime for 4 weeks and then 0.5 mg.  No other changes in treatment.  
 
Only had six CH and all but one were a 2 or so and the worst was a 4 or 5 and lasted 10 minutes (rather than 45) and that was after daring to drink 4 glasses of wine.  
 
Went without a CH for 10 days and this is the first time in 3 years that I have had more than 5 days without one.  
 
I only hope it keeps working, but this is a very low dose so if it stops working, I can up it.  The pills are so cheap it is worth trying.
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Re: Melatonin
« Reply #13 on: Oct 27th, 2003, 2:40pm »
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I've been using it for a week and a half.  I have been painfree for three days.  If you look at my post that starts with "This isn't a cure but..."  You'll see what has broken my cylce just after 3 weeks.
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Re: Melatonin
« Reply #14 on: Oct 27th, 2003, 8:20pm »
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I must say that although I've tried 3 mg with no success, I'm still intrigued about trying 9 mg.  Of course, sleepiness will actually be a problem in my case... but I'm wacked like that.  Does anyone know if that much melatonin may be harmful?
 
http://www.rxlist.com/cgi/pharmclips2.cgi?keyword=%20Melatonin#effects
 
The drowsiness and sleepwalking could be significant problems for me.  I'll be researching.
 
--- Steve
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Re: Melatonin
« Reply #15 on: Oct 28th, 2003, 8:51am »
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From everything I've seen, I don't think that it will harm you.  However, you may have a hang over type headache the next day if you use too much.
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Re: Melatonin
« Reply #16 on: Oct 28th, 2003, 9:03pm »
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I used this at 9 mg at night then bumped it up to 12 mg with no positive results. DC after a few weeks.
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Re: Melatonin
« Reply #17 on: Nov 4th, 2003, 12:55am »
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Here's my update:  SIXTEEN days and not even a shadow!  The last CH was from drinking four glasses of wine and it was ten days pain-free before that.  (Usually even one drink causes a 8 to 10er.)  
 
This cannot be a coincidence but I am still finding it hard to believe.  
 
The biggest difference is in not being afraid and always feeling like I'm just waiting for the next one to sneak up on me....I kick myself every time I think about the fact that I had a bottle from the dollar store sitting around for two years without taking it--I got it to use for jet-lag, not CH.
 
If anyone has not tried Melatonin, I highly reccomend that they do so, keeping in mind that it is apparently a trigger for some people.
 
(Still taking 0.5 mg 15 to 30 minutes before bedtime.)
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Re: Melatonin
« Reply #18 on: Nov 4th, 2003, 1:47am »
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Great news that it is working for you. I believe it actually did help me .... for a few days .... then back to normal CH's. If others haven't tried it...it's worth the try.
 
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Re: Melatonin
« Reply #19 on: Nov 5th, 2003, 7:39pm »
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I think I am going to try, a bit of a higher dose. I have been taking 3mg about an hour before I plan on trying to get some sleep and there is not any effect.  Going to try more and see how it goes.  That is great news that it is helpful to some.  I hope that is works for me as well.
 
Tiannia
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Re: Melatonin
« Reply #20 on: Nov 29th, 2003, 2:09pm »
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Re: Melatonin
« Reply #21 on: Nov 30th, 2003, 9:52am »
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I have had some success with Melatonin,
 
I am on 17 mg right now, it has stopped the 3 am hits and the other two are much less but fatigue is starting to set in. I am going to try to reduce to 15mg and find a happy medium.
 
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Re: Melatonin
« Reply #22 on: Dec 1st, 2003, 9:36am »
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on Jun 21st, 2003, 9:02am, Giovanni wrote:
This relief may have been somewhat coincidential in that the cycle might have been tapering/ending anyway, but I do feel the melatonin has had a positive affect.

 
Thanks so much for the info Giovanni. I have tried Melatonin for the last 3 days now. Was waiting to see the results before posting. I slept 3 days in a row without my usual 2:30 A.M. meet & greet with the beast. I agree it may be coincidential because the cycle should have ended by now anyway. Still had CH's during the last 3 days, but not in the early A.M.
 
Update:  Another day has past. Looks like all it did was move the CH's from the usual 2AM meet & greet to the now 5AM meet & greet with the Bastard.
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Re: Melatonin
« Reply #23 on: Dec 7th, 2003, 9:21am »
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I tried 10mg melatonin at bedtime.  It did not do any good at all for me as far as CH goes, and the reaction I had was that it made me unable to sleep (I know, makes no sense).
 
Anyway, good luck.
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Re: Melatonin
« Reply #24 on: Dec 8th, 2003, 11:30pm »
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I am now up to 43 days with no CH, not even a shadow.  It's like being a a normal person again, or at least as close to normal as I was before I started having clusters.  
 
I am still taking 0.5 mg of melatonin at bedtime.  I tried adding a 3 mg time release tab to see if it would help me sleep longer (I usually only sleep 5 or 6 hours max) but it gave me a non-cluster bilateral headache a couple of times and didn't seem to help me sleep any longer.  It made me sleep for a shorter period of time at least twice.
 
Some of the research I did indicated that if the melatonin isn't working, you should REDUCE the dose rather than increase it.  I started out with 0.3 mg but still had some mild CH and shadows.  The 0.5 seems to be the ticket for me.  I think these 9 mg + doses are way too much.  This does seem to be counterintuitive as most meds you need to increase the dose if it doesn't work.
 
I would suggest that everyone with CH should buy a bottle of 0.5 mg melatonin tabs (I got 200 for under $4 at Vitamin Shoppe) and trying one at bedtime for a few days;  if no relief, two for a 1 mg dose; then three for a 1.5 mg dose.  That way if the melatonin is going to work you should find the right dose.  I guess this would be like titrating an IV drug.
 
If you can't find 0.5 mg then you can break 1 mg tabs in half.    
 
If you have tried the larger doses of melatonin without results this is still worth a shot.  It may very well be that there are multiple root causes for CH, but if this helps even a few of us, it's worth trying.
 
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