It's been 7 weeks now since my cycle started, which i show long the first one went for. I haven't used the O2 for over a week, and killed a few little hits with red bull and voltaren. Some really little ones, I've just let run their course, but not in maybe 3 or 4 days. The last couple of days, I've had some bilateral sinus and ear pain, but I think I may actually have a sinus problem at the moment, although the doc said my ears were clear.

I'm on 100mg topamax 2xday, and 90mg verapamil (I know that's a really low dose... but I'm sure the headache specialist didn't want me to increase it yet????

How do I know the difference between the prevents working and the cycle ending? Does less/milder headaches = prevents working and no headaches = cycle ended?

I think the only way to know for sure is to wean off of your prevents and see what happens.  I, however, wouldn't do that until you have gone at least two weeks totally PF.

Jeannie

Jeannie's right - two weeks pain-free before you start titrating them downward.

I know I'm done when I can go a month with no hits.  I was extremely lucky this go around I started the day after Christmas and  I was done in 5 weeks with only minor hits.  To me when I say minor I mean I wasn't getting major hits every day couple times a day.  This cycle was really weird.  Hope you soon will be in pain free bliss.

Blessings,
Sami

I use the same rule of thumb as above. 2 weeks totally pain free and I start to wean off my prevent very slowly. If I get hit I ramp back up again. Have you and your doc discussed an exit strategy? I use lithium, I go from 1200 mg a day to 900, wait 2 days, go to 600 etc. I haven't used verap or topomax so I'm not sure if you need to wean slowly. Might be worth a quick call to the doc to see how they want you to come off.

Good luck, hoping it's done this go round.

Joe

Joe's right, you need a dr approved exit strategy. These meds are nothing to mess with. I would also add that it is possible the prevents are working, and the CHs will return once you begin titrating off them. I pray that won't happen, but be alert. If they start to return to cycle patterns, contact your dr and seek advice on going back up to therapeutic levels. Just a thought, in the hopes you won't need to. Blessings. lance

Thanks guys for all your answers.

On my previous cycle (which was my first), I went 7 weeks then the pain totally disappeared, then came back 4 weeks later. I was on no meds at that stage. Now it's been 7 weeks and the pain has gone. Let's hope I get more than 4 weeks break this time.

My kind and wonderful GP wrote me a script for 200mg tabs of topamax, so I can take 1/2 tab twice a day, which makes a pack last 2 months - instead of the stupid neuro who gave me 25mg tabs, and told me to go up to 100mg twice a day, meaning I'm filling a script a week. The only problem is, I just found out that the government doesn't subsidise the scripts for "migraines" (I doubt they have even heard of CH) unless you have tried betablockers and had adverse reactions to them - it's not enough that they didn't work, you actually had to have been ill as a result of taking them. Go figure. So I've decided to cut back the dosage anyway to 75mg twice a day, just to save some money. And yeah, I DO need to get onto the Headache Specialist With Whom I Am In Love to find out where to go from here.