Started to get hit last week so i started my Verapamil back up and my Zomig. Both of these work well just need the Verapamil to get on a good dose for me. So I have been away from here for quite sometime. I hope you guys have been having some pain free days.

Sorry the beast has taken up residence in your noggin again! Nasty habit he has of ALWAYS coming back! Good to see you again. Hoping you catch a short go this time around.

Joe

Sorry he's back.  Glad your weapons are in order.

Now kick his ass!!!

-Dennis-

I'm so sorry to hear that the beast is back. I do hope that the visit will be a short one and followed by a nice, long remission.

But welcome back here! :)

Sanna

Thanks for the warm wishes guys. I am just glad to be able to treat these and have a place to go where there are others who suffer like I do. I am a fighter so I will not back down from these!!!

hey man. lebowski  fest is coming up july 10. you should go. bring some o2

One of my goals  is to attend a LF. Chicago this year I think>? I am thinking of organizing a showing here at Cornell one night having people show up dressed as their favorite character and drink white russians.

Thinking of bumping my Verapamil dose up to 120mg. Currently on 80 and it was working for a little bit but I have been getting hit pretty hard the past few days. Since I have switched to 4pm - 2am shift this month they really come on strong.

That's low.......talk to doc before playing on your own.

Feel good

I agree.  I started at 240 mg/day, went to 360mg/day, and am now at 480 mg/day.  Talk to your doc before Verapamil dosage is changed.  Verapmil is a blood pressure med , and if you take too much, your BP could possibly go too low.  As it is, if my neuro ups my dosage any higher, I'll have to get EKGs periodically, due to the fact that at Verapmil dosages above 480 mg/day, there is a risk of heart arhythmia.  Like any drug, Verapamil has its side effects.

Neuro would not give me any advise until I came in on my appointment but my regular doctor told me that i could go up to 160mg as of now but to watch my blood pressure. I am doing good tonight just a little shadowing for now. Ready to slay this beast seriously. Appreciate the words guys.

Hey BL,  you may or may not have read this before.  Bob Johnson posted it a while ago.  The abstract spells out the best approach for getting results from Verapamil and worked wonders for my treatment.

Based on everything I've read, 160mg seems a bit low to me. Though your Dr is certainly the best person to say that for sure.  Just make sure he/she is using this guideline or is at least aware of it.

Good luck...

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE


Quote:

Brief Communication Individualizing Treatment With Verapamil for Cluster Headache Patients Joseph N. Blau, MD, FRCP; Hans O. Engel, FFOM, LRCP&SE Address all correspondence to Joseph N. Blau, MD, FRCP, City of London Migraine Clinic, 22 Charterhouse Square, London EC1M 6DX, UK. From the City of London Migraine Clinic. Copyright 2004 By the American Headache Society KEYWORDS cluster headache • treatment • verapamil (Headache 2004;44:1013-1018) ABSTRACT 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. -------------------------------------------------------------------------------- Accepted for publication July 19, 2004.

-Dennis-