I suffer badly from these headaches and currently take cardinol, a beta blocker, to manage them. It seems to be working quite well but I still have cafergot tablets as a back up.

Welcome Graemel to the club no one wants to be a member of!  Glad you found us and I hope you find the added support you need here. 

This site is loaded with info on CH and many knowledgeable people to help when you have questions.  So read all you can here to learn more about CH and make sure you check out the Oxygen page. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Cardinol is also known by many as it's generic name Propranolol, my son started taking it when he was 2 years old due to migraines.  Not sure if there are to many CHer's here who use it; as Verapamil has proven to be the biggest help or even Lithium if Verapamil doesn't work.  I use Verapamil as a CH prevent and Imitrex shots or nasal and O2 as abortives.

You may want to discuss different options with your Dr. if the Propranolol proves ineffective for your CH.

Wishing you many PF days and nights!

Hey welcome to the board. No offense but your current regimen speaks of a doctor not up to date with CH. I was prescribed cafegot tablets in the early 80's! We've come so so far since those dark ages! ;)

Verapamil is one of the first line prevents for CH. By prevent I mean the med you take daily while in cycle to reduce your hits. We tend to take it at doses higher then most GP's are comfy with, some go as high as 960 mg a day to get relief. Lithium and Topomax are also popular prevents with many on the board. Lithium being my magic bullet, blocks 60-70% of my attacks.

Abortives.....your attack starts now what? Oxygen should be your first line abortive. Hate to sound like a revivalist preacher but Lordy 02 has changed my life!!! 6-8 minutes and the attack is gone, beats the hell outta the 90 minute rides I used to take. Read the oxygen info tab on the left side as it must be used correctly or it won't work.

Imitrex injectables are very effective, the imitrex nasal spray works well for many, the tablets take too long to get in your system to be much use. For now try chugging an energy drink at the first hint of an attack. I prefer sugar free Red Bull, just cuz of taste, but any containing caffeine and taurine are effective. Will abort or reduce attacks for many. I chug one as I start the 02 for a 1-2 punch.

You need to find a headache specialist neuro or a  GP who will let you educate him/her. These things hurt too damned much to let the lack of a doctors knowledge make you endure unnecasary hits. We'll help you all we can, glad you found us.

Joe

I have some speculation that the beta blockers I was given, (intravenously) ended my last cycle, or knocked all my CH's to a kip 1 or 2.

I haven't had a bad CH since being medicated, and since Verapamil is also a beta blocker, maybe theres a connection.
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Maybe the point is moot, but I would guess that a one-time injection of one beta blocker would be a more preferable route then Verapamil dosing. I know nothing on Verapamil dosing, but perhaps the side-effects might be an issue.

PlayDoh wrote on Jul 24^th, 2010 at 8:32pm:

I have some speculation that the beta blockers I was given, (intravenously) ended my last cycle, or knocked all my CH's to a kip 1 or 2. I haven't had a bad CH since being medicated, and since Verapamil is also a beta blocker, maybe theres a connection. http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1278269550/3#3 Maybe the point is moot, but I would guess that a one-time injection of one beta blocker would be a more preferable route then Verapamil dosing. I know nothing on Verapamil dosing, but perhaps the side-effects might be an issue.

Verapamil is a Calcium Channel Blocker Not a beta blocker. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE   ;)

Quote:

From Article; Unlike beta blockers, CCBs have not been shown to reduce mortality or additional heart attacks after a heart attack.

Ginger, I have detoxed from all meds except Verapamil. I feel like it may be keep me PF since my last cycle ended 2 weeks ago. I get very mild shadows in the morning and evening, but a red null or tylenol is enough. Don't hit the O2 at all. What do you think if Verapamil as a preventative?

jayhedges wrote on Jul 25^th, 2010 at 6:50am:

Ginger, I have detoxed from all meds except Verapamil. I feel like it may be keep me PF since my last cycle ended 2 weeks ago. I get very mild shadows in the morning and evening, but a red null or tylenol is enough. Don't hit the O2 at all. What do you think if Verapamil as a preventative?

Many here take Verapamil as a prevent Most take it in regular form not the SR like me.  Many find Verapamil very affective. 

I take the SR (sustained release) Verapamil because it seems to work better form me, apparently I can't handle the up and down of medication in my system from the regular verapamil, I need to have a steady stream of it so I am on the SR version.  It works as well as can be expected for me, I was getting up to 19 hits per day before medication now I am down to 1-2 CH hits per day. 

So what do I think of verapamil as a prevent ? 
I think 1-2 hits per day is a Heck of a lot better than friggin 19!   ;D

Prop. is a very old migraine med which, 30-yrs ago, was found to be fairly unhelpful for Cluster.

Throwing some material on currently used meds which are mainline approaches:

PDF file below.
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Here is a link to read and print and take to your doctor.  It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S.  (2002)
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Michigan Headache & Neurological Institute for another list of treatments and other articles:

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Cluster headache.
From: START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]

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