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New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Melatonin
(Message started by: Giovanni on Jun 21st, 2003, 9:02am)

Title: Melatonin
Post by Giovanni on Jun 21st, 2003, 9:02am
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

Title: Re: Melatonin
Post by Bob_Johnson on Jun 21st, 2003, 12:45pm
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.

Title: Re: Melatonin
Post by ijunG4 on Jun 24th, 2003, 5:09pm
I've tried Melatonin before with inconclusive results--but not at 10mg.

I'll give it another shot with 10mg this time.

Title: Re: Melatonin
Post by Koda on Jun 25th, 2003, 2:08am
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

Title: Re: Melatonin
Post by ZAIRA on Jun 25th, 2003, 2:54pm
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

Zaira :)

Title: Re: Melatonin
Post by ijunG4 on Jun 26th, 2003, 7:55am
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.




Title: Re: Melatonin
Post by jnesbitt on Jul 1st, 2003, 8:56pm
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.   :-/

Title: Re: Melatonin
Post by Nathan on Jul 8th, 2003, 8:49pm
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

Title: Re: Melatonin
Post by NewHeadPLZ on Jul 10th, 2003, 12:38pm
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  >:()

Art

Title: Re: Melatonin
Post by jnesbitt on Jul 10th, 2003, 7:52pm
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.  :-/

Title: A lot more than getting sleep...
Post by Georgia on Jul 11th, 2003, 3:47am
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.


Title: Re: Melatonin
Post by Giovanni on Jul 11th, 2003, 6:29pm
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.  ;D

Title: Re: Melatonin
Post by t_h_b on Oct 26th, 2003, 2:16pm
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.

Title: Re: Melatonin
Post by thomas on Oct 27th, 2003, 2:40pm
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.

Title: Re: Melatonin
Post by eyes_afire on Oct 27th, 2003, 8:20pm
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

Title: Re: Melatonin
Post by thomas on Oct 28th, 2003, 8:51am
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.

Title: Re: Melatonin
Post by Unsolved on Oct 28th, 2003, 9:03pm
I used this at 9 mg at night then bumped it up to 12 mg with no positive results. DC after a few weeks.

Title: Re: Melatonin
Post by t_h_b on Nov 4th, 2003, 12:55am
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.)

Title: Re: Melatonin
Post by Unsolved on Nov 4th, 2003, 1:47am
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.

Unsolved

Title: Re: Melatonin
Post by Tiannia on Nov 5th, 2003, 7:39pm
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

Title: Re: Melatonin
Post by thomas on Nov 29th, 2003, 2:09pm
bump

Title: Re: Melatonin
Post by Opus on Nov 30th, 2003, 9:52am
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.

Opus/Paul

Title: Re: Melatonin
Post by BlueMeanie on Dec 1st, 2003, 9:36am

on 06/21/03 at 09:02:21, 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.

Title: Re: Melatonin
Post by CJNine on Dec 7th, 2003, 9:21am
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.

Title: Re: Melatonin
Post by t_h_b on Dec 8th, 2003, 11:30pm
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.


Title: Re: Melatonin
Post by Giovanni on Dec 9th, 2003, 7:51pm
http://www.mhni.com/clusterheadaches.html

Melatonin




Natural sleep hormone that is not produced in normal amounts by cluster patients. This may be an inciting factor in cluster headaches that occur in the night
Can be used along with other cluster medications; may be able to use a lower dose of other medications when used with melatonin
Trials have shown that fairly large doses can stop cluster attacks. Suggested dose is 6 to 9 mg at bedtime
Purchased over-the-counter and appears to have minimal side effects. No current governmental regulation; therefore, if one brand does not help, trying another brand of melatonin may be worthwhile
Should consult physician before starting

Title: Re: Melatonin
Post by t_h_b on Dec 10th, 2003, 12:06am
Yes, I've seen all of those articles, too. There really isn't a definitive body of research on the use of melatonin.  For instance, there are only a couple of studies that measure blood levels achieved from oral melatonin.  But our bodies don't really  make a huge amount of melatonin.  Hormones are generally fairly potent.  Some articles suggest lower dosages and it's the lower dose that works for me.  I just happened  to have 0.3 mg tablets when I started taking it.  0.5 mg has eliminated my headaches and my neurologist believes that it is not a coincidence.  I am chronic and that may make a difference, too.

http://sleepdisorders.about.com/cs/melatonin/a/melatonin_4.htm

Melatonin is often administered in far too high a dosage. When this happens, the hormone remains in the blood stream and can cause daytime drowsiness, confusion and that headachy, hangover feeling. In some cases, too high a dose can even cause insomnia, the exact opposite of the result hoped for.

A dosage as small as one mg. or even less can cause drowsiness. Start with a very small amount and work your way up to a dosage that works for you. Never take more than you need, and take it only at bedtime.

http://www.websciences.org/sltbr/melfaq.htm

How much melatonin does the body produce?

Healthy young and middle-aged adults usually secrete about 5 to 25 micrograms of melatonin each night - at least 80 times less than is in the commonly sold 2 milligram (mg.) tablet or capsule. The amount of melatonin the body secretes tends to decline with age, a possible link with an age-related rise in difficulty sleeping.

What is the appropriate dose range for melatonin pills or capsules?

Major questions in the research community are whether and how much melatonin is effective for the various applications described below. Recent studies mainly have used doses from 1/2 to 5 mg. Debate still centers around the essential action of the hormone - shifting the biological clock, promoting sleep, or both. Some studies have found clock-shifting results at the very lowest doses (1/2 mg.). Studies emphasizing sleep-promoting action have tended to use somewhat higher doses (2 to 5 mg.), although it is not certain that these are necessary to achieve the desired effect. Although these questions are not yet resolved, a basic clinical principle is to use the lowest dose effective for the individual and to work upward, if necessary, with a physician's guidance. The popular impression that "more works better' has not been borne out in many studies of melatonin, and larger doses probably carry a higher risk of undesirable side effects.

http://www.wholehealthmd.com/refshelf/substances_view/1,1525,804,00.html

Migraine        
1-3 mg at bedtime to improve sleep. The lower dose should be tried first. If necessary, gradually increase the dose. Doses lower than 1 mg may also work.

Preparations

Melatonin is available over the counter in varying doses of up to 3 mg per tablet. However, a fraction of this is required for insomnia, usually about 0.3 mg or less. Too much melatonin or taking it at the wrong time can interrupt normal circadian patterns. Melatonin is produced at its highest level in the pineal gland during darkness. Since melatonin occurs naturally in some foods, it can be sold as an over the counter dietary supplement. It is only one of two hormones (the other is DHEA) not regulated by the U.S. Food and Drug Administration (FDA). Natural, animal, and bovine melatonin supplements contain actual extracts from pineal glands. Synthetic melatonin is made from non-animal ingredients and is suitable for vegetarians. It is similar in molecular structure to melatonin produced in the body.

http://www.findarticles.com/cf_0/g2603/0005/2603000516/p2/article.jhtml?term=

The proper dosage is not known, but it appears to differ greatly depending on the individual and extent of the sleep disorder. Persons starting the hormone should begin with a very low dose, 100-300 mcg, which is 0.1-0.3 mg, or less, and gradually increase the dosage if needed. Melatonin is quick-acting and should be taken about 30 minutes prior to bedtime. For jet lag, the general recommendation is 300 mcg just before boarding the flight and 1.5 mg after arrival before going to bed. Melatonin should not be taken during the day.

Title: Re: Melatonin
Post by t_h_b on Dec 10th, 2003, 12:33am
One more thought:  I keep reading the same couple of phrases copied over and over again all over the internet about how a high dose can cause drowsiness the next day.  The half-life of melatonin is certainly less than an hour.  May be under half an hour.  I don't remember how to calculate the levels left after a period of time based on the half-life, plus the half-life and the absorption rate are not known exactly.  But no way is there any significant amount left in the plasma seven or eight hours later.    

So either a.) it does NOT cause drowsiness the next day and such a statement is total B.S. or b.) even the miniscule amount that would be left after eight hours can have an effect.  Take your pick.

I would love to have a couple of people try the low doses and see if it helps. My guess is that there is probably no one thing that would help everyone; it is so damned sneaky and unpredictable.  But I would like to know for certain that this isn't just a very, very, very unlikely coincidence.  If I had cycles I would tend to think it were more likely to be a coincidence.  But I had gone only five days max without a CH for three years, and that just a couple of times.  The melatonin started working the first night I took it.


Title: Re: Melatonin
Post by jflynn on Dec 11th, 2003, 4:10pm
The melatonin most certianly works for me.  6-9mg is what I'm doing.  Those nights I forget to take my dose will be the nights I wake up at 1am with my right eye about to pop out.

Title: Re: Melatonin
Post by t_h_b on Dec 14th, 2003, 3:17pm
The ultimate test:  two stiff drinks last night, enough to make me a little tipsy, but no sign of a CH.  

Now at 49 days with no CH or shadows.

Title: Re: Melatonin
Post by Paigelle on Dec 15th, 2003, 8:34am
How long did it take for the melatonin to start working for you all?  Also can I take it with 20mg of Inderal?  

Title: Re: Melatonin
Post by floridian on Dec 15th, 2003, 9:28am

Quote:
So either a.) it does NOT cause drowsiness the next day and such a statement is total B.S. or b.) even the miniscule amount that would be left after eight hours can have an effect.  Take your pick.


When I take a 3 mg tablet (1/2 time release, 1/2 quick release), I am definitely more likely to sleep through my alarm clock the next morning, and be tired that day.  It may change the sleep structure.  Even though melatonin may be eliminated in a few hours, it has triggered some changes that persist longer.  

Title: Re: Melatonin
Post by t_h_b on Dec 15th, 2003, 8:27pm
Paigelle, the melatonin starting working the night I started taking it (0.3 mg).  I still had occasional mild CHs and shadows until I increased the dose to 0.5 mg.  I was perfectly content with one CH and a shadow or two every week (I had 1 to 3 a day, almost every day, for three years) and started the 0.5mg only because I couldn't find any 0.3 mg tablets and didn't think that I could break 1 mg tablets into 3 pieces.  

I don't know of any reason not to take melatonin with Inderal/propanalol but you should ask the physician who prescribed the Inderal for you.  Melatonin is a serious drug even though it is over-the-counter in the US--it is a hormone and requires a prescription in many countries.


Floridian, melatonin definitely affects different people in different ways.  Have you tried a smaller dose?  When I took 3mg of sustained-release with the 0.5mg of regular melatonin, it interfered with my sleep and caused non-cluster headaches.

Maybe there is a series of abnormalities that are inter-related or inter-dependent, any one of which can cause CH.  That may be why different medications and treatments work for different clusterheads and that may be why some people are chronic and some have seasonal CHs.  I am chronic.  Obviously melatonin doesn't work for everyone or this message board wouldn't even be here!

For a bit of irony only other clusterheads could understand:

Finally my insurance company approved my oxygen--after I sent a 20+ page letter completely describing CH in general, my history and condition, prior and current treatments, studies supporting the use of oxygen (from here and elsewhere), etc.  They had given me 10 vials of Imitrex a month with no hassle.  (Different departments approve pharmaceuticals and oxygen.)  It took over two months to get it approved, and now I don't really need it!  

Title: Re: Melatonin
Post by jflynn on Dec 16th, 2003, 1:19pm
Agreed, I am now often late for work but no more CH.  It started working for me in about 3 days.  I will try reducing dosage.

Title: Re: Melatonin
Post by t_h_b on Dec 29th, 2003, 9:45pm
Broke my no-headache streak by drinking way too much last weekend.  Imitrex shot slapped it down in under ten minutes and I kept on drinking and no CH since.  Still taking melatonin 0.5mg at bedtime.

Title: Re: Melatonin
Post by jflynn on Dec 29th, 2003, 10:28pm
UPDATE:

I've reduced my usual dose to 3mg and pain free, can wake up as easy as normally.  6-9mg is apparently too much for me.  3mg seems perfect, less might also work well.

Title: Re: Melatonin
Post by t_h_b on Dec 30th, 2003, 7:00am
It's really hard to screw around with your meds once you get relief.  I'm still taking meds that probably aren't necessary but it's not worth the risk of having CH in order to dump them.  Maybe after a year?  If doing the hokey-pokey every morning in the shower worked, I would do it.....

If the 3mg is working, I probably wouldn't be able to work up the courage to mess around with it.  

Title: Re: Melatonin
Post by jflynn on Dec 30th, 2003, 9:54am
Agree 100% with above statement, "if it ain't broke don't fix it."

Since I've no negative side effects and the meds are working I'm afraid to fiddle with dosage.  But still, less is almost always better if it works.

Title: Re: Melatonin
Post by thomas on Dec 30th, 2003, 10:09am
I was off all meds in 3 weeks after the melatonin, ssri, magnesium combo, and have been pf ever since.  I'm glad you guys are having good luck with something so cheap and readily available.



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