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CindyC
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MY QUESTION IS......
« on: Nov 26th, 2003, 2:01am »
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Hi all....
My hubby has CHs.  He has been taking prednisone, and verapamil,  We thought things were getting better there for a few days.  He has finished his pred taper...and still on the verap.
Today has been a bad one.    
MY QUESTION IS....
When is it safe to do another dosage of prednisone?
I think he finished it up before the verap had a chance to start working?
Any opinions on the restarting the prednisone?
Thanks
CindyC
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Re: MY QUESTION IS......
« Reply #1 on: Nov 26th, 2003, 2:06am »
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Hi Cindy,
 
My suggestion is to call his doc for advice on the Prednisone.
 
The dr may not want him to restart.   Couldn't hurt to give him a call.
 
PF vibes to your hubby.....     Cool
 
Jean
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CindyC
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Re: MY QUESTION IS......
« Reply #2 on: Nov 26th, 2003, 2:11am »
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Thanks Jean....
I guess he (the doc) wouldn't appreciate a call this time of night!
Hubby is having a bad one right now....
and for some reason I jump on the message boards...
Can't do anything else to help him!!!!!!
CC
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Re: MY QUESTION IS......
« Reply #3 on: Nov 26th, 2003, 2:32am »
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Cindy,
Sorry, I didn't realize he was in the midst of an attack.
 
I have been PF for 78 days due to Prednisone taper.
 
I have to say.....IF I were to have a CH tonight......I KNOW that I would more than likely take the Pred.
 
No guarantee that it will work the 2nd time.  But I would probably do it......and call my dr tomorrow.
 
Hope you didn't think I was being insensitive.  I was not aware that he was in the middle of a CH at the moment.
 
PF vibes  
 
Jean
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Re: MY QUESTION IS......
« Reply #4 on: Nov 26th, 2003, 4:42am »
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Cindy, I bet the doc will not ive another round of pred and that may be wise.
 
IOf you haven't tried it before, ask the doc for Imitrex (injections, not pills!) or, and this has some preference with me, for it is innocuous compared to either pred or trex, oxygen! Provided you use it the right way it may be a godsend. It has been for many. Click the button on the left of this page for more info. Then go and ask your doc.
 
Good luck
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Re: MY QUESTION IS......
« Reply #5 on: Nov 26th, 2003, 9:19am »
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on Nov 26th, 2003, 2:01am, CindyC wrote:
   
MY QUESTION IS....
When is it safe to do another dosage of prednisone?
 
CindyC

 
Prednisone usually isn't prescribed by doctors that understand the damage it can cause by too much use, more than two dosepacks per year.
 
PF
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Paigelle
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Re: MY QUESTION IS......
« Reply #6 on: Nov 26th, 2003, 9:25am »
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Maybe this will help:
 
Prednisone
"For the episodic form of cluster headache, prednisone is highly effective in over 75 percent of patients (Kudrow, 197Cool (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, 197Cool.  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."
 
This is taken from the medical info on the side of this website.
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CindyC
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Re: MY QUESTION IS......
« Reply #7 on: Nov 26th, 2003, 11:46am »
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Thanks for all the info folks!
We are new to this state, the nuero we want to see won't see hubby without insurance.  We are in the process of getting that.
The info we have found here has been priceless...
 
Jean...no problem...we made it through...the sun came up and today is a new day!
 
Yes..we knew the pred was dangerious.  He had only done an 80 to 5 taper in about a week and a half.  Mid week he had 3 good days.  So we think the pred was working...but quit following the taper.  This seems to be what happens to many.
 
We probably can't get in to see the nuero til after the first of the year...we have enough verap to last that long and enough pred to do 1 more taper like I discribed above.
Our saving grace right now is O2...(from a welding supply)
So basically we are winging it until we can see a doc!
Thanks again for the info and the many well-wishes!
CindyC
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Re: MY QUESTION IS......
« Reply #8 on: Nov 26th, 2003, 6:53pm »
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on Nov 26th, 2003, 11:46am, CindyC wrote:
We probably can't get in to see the nuero til after the first of the year...

 
Cindy,
 
There is no real reason to wait to see a neuro just to get a handle on these things...
 
If you find a GP that is willing to listen, give him/her some printed info from this site and see if you can get started in a direction that you want to go.
 
I personally prefer a neuro, but I was diagnosed by a GP and prescribed trex and O2 (both have yielded results) from GPs.  
 
Depending on what neuro you want to see, there can be a waiting time of over a month...I went through that.
 
Some GPs are just jerks though...
 
Regards!
Chris
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Re: MY QUESTION IS......
« Reply #9 on: Nov 26th, 2003, 7:22pm »
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Hi CindyC,
 
Sorry your husband going thru a rough bout now.  I personally do not recommend a second round of prednisone.  I have been there and done that with numerous complications and still had the headaches.  
 
One cheap thing you can try now is Melatonin @9mg each night before bedtime.  Melatonin has worked wonders for some of us here (and others no help).  It is cheap and available at GNC and other places.
 
The imitrex stat dose works in minutes for most of us in aborting an individual attack--when you can get it.  Beg the new doc for some imitrex samples when you see him/her.  Good luck.
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Billlh
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Re: MY QUESTION IS......
« Reply #10 on: Dec 2nd, 2003, 10:52pm »
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I'm sorry to hear about your husband. I've been taking pred and verap periodically from Jan last year up till July. It would cease the Cluster's within three days which was the the first time in 12 years I had any type of relief because of misdiagnosis. But as of this Aug. It quit working, worked my way up to 80mg's a day and all it did was make me fat, 24 hour indigestion and looked like hell. Did that for 65 days, and still suffered the demon. The only relief I got was from the Maxalt MLT and almost constant o2 at night, I can't stress enough how the o2 has helped. After the Pred my Doc switched me to Topamax worked up to 150 mg's and that did the trick, after 90 days I finally have had 5 nights of sleep. Keep working with your doc daily by phone if need be, meds that worked in the past may not work in the future, there are are also powerful narcs that can be perscribed like Butorphanol Tartrate Nasel Spray, I have used this twice in the past when nothing else has worked, and the the pain is a 10 +, it works, but not to be abused. I hope your husband will find relief, Bill
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