I am a Pharmacist and chronic sufferer of CH's and I do several things to help keep them at bay.  First of all I generally get them right at bedtime and then again right before I wake (rather they wake me early).  During the day I have the twinge in my left eye like I am going to get one but it never happens.

I have started using a quarter of a hundred mg imitrex 4 times a day to help prevent.  Then as one comes on I have a clay based ice pack that I wrap around my neck pressing on the occipital nerve root.  Then I apply pressure just above both sides of my temples.  Occasionally I will do this weird tapping all over my head to distract.  Also, if it gets really bad I will use O2, but I don't lug the tank to work.

I personally have had much better results with ice than heat.  Also, the vicks sticks I use during the day.  It helps distract the sinus and has lesdexamphetamine which works as a potent vasoconstrictor.

I would be interested to do some compounding of a little gabapentin (to slow nerve impulse via gaba receptors) and the triptans.  Any thoughts anyone?

Try Batch's      Anti-Inflammatory Preventative Regimen for Cluster Headaches. It worked the first night I tried it, and I was pain free on the second night. Been PF since.

A multi-vitamin, covers the Magnesium & zinc, and I haven't even added Vitamin K yet, although I will soon.

Omega 3 Fish Oil - 2000 to 2400 mg/day (EPA 360 mg/day, DHA 240 mg/day)
Vitamin D3 *      - 10,000 IU/day
Calcium **         - 500 mg/day (calcium citrate preferred)
Magnesium         - 400 mg/day (magnesium citrate or magnesium gluconate)
Vitamin K ***     - 120 mcg/day
zinc                    -   10 mg/day
Boron                 -     1 mg/day   

This regimen can be taken any time of the day, but it's best taken in the morning with an 8-oz glass of lemonade, limeade, or any fruit juice high in citric acid sweetened with with a little honey.  Honey is a natural source of Boron, which is listed as one of the "cofactors" along with magnesium, vitamin K and zinc. by Batch

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Give it a try if you haven't, it certainly wont hurt. You could be pleasantly surprised as I was. Please if you do give it a try, please provide some feed-back via a quick survey. I would be happy to provide you a link to the survey once your ready.

If possible, perhaps you could have your 25(OH)D serum levels checked prior to trying the regime but certainly not necessary. Being a Pharmacist I'd guess these vitamins are available at your work. lol you don't even have to shop.  ;)

Are you using any preventives, like verapamil, lithium or topomax?

Tried energy drinks like Red Bull with taurine and caffeine?

McPharmD wrote on Dec 11^th, 2011 at 11:23pm:

I am a Pharmacist and chronic sufferer of CH's and I do several things to help keep them at bay.  First of all I generally get them right at bedtime and then again right before I wake (rather they wake me early).  During the day I have the twinge in my left eye like I am going to get one but it never happens. I have started using a quarter of a hundred mg imitrex 4 times a day to help prevent.  Then as one comes on I have a clay based ice pack that I wrap around my neck pressing on the occipital nerve root.  Then I apply pressure just above both sides of my temples.  Occasionally I will do this weird tapping all over my head to distract.  Also, if it gets really bad I will use O2, but I don't lug the tank to work. I personally have had much better results with ice than heat.  Also, the vicks sticks I use during the day.  It helps distract the sinus and has lesdexamphetamine [lisdexamphetamine] which works as a potent vasoconstrictor. I would be interested to do some compounding of a little gabapentin (to slow nerve impulse via gaba receptors) and the triptans.  Any thoughts anyone?

Vicks Inhaler Nasal Stick

Active ingredients:
Menthol 125mg, camphor 50mg, siberian pine
needle oil 10mg. Also contains methyl salicylate.
Nasal stick (0.5ml medication) for nasal use.

  So the Vicks stick doesn't contain Lisdexamphetamine.

    A quarter of a hundred mg. of imtrex would be 25mg.  four times a day.

Hmmmmmmm.  Just sayin.

          Potter