It's an alpha 2 adrenergic receptor agonist that I was prescribed to help my shadows. It takes about 15-20 minutes to kick in for me (2mg) and helps the muscles in my face relax to relieve some of the residual or precursor facial pain from headaches. My neuro's hypothesis is that the muscles around the trig nerve can tighten and stress, causing more facial pain, and relaxing them should reduce some of the irritation from the nerve activity.
Anyone else tried this? I think it's working for me when I need it. Keep it mind, it could all be the placebo effect, but I think it's helping me somewhat.
edit: the reason I bring this up is I've recently found out that Clonidine (another muscle relaxer which similar mechanism of action) has a transdermal patch. I cannot stand taking pills as you guys know from my previous post, and if that could help, I might look into it.

From 2010 there was a discussion on it:


Not much literature on the use with CH. A VERY small clinical trial seems to have been conducted on chronic CH patients. Found an excerpt and a site where the full text is available.

"Tizanidine for Chronic Cluster Headache"
Roberto D'Alessandro, MD
Institute of Clinical Neurology Via Ugo Foscolo 7 40123 Bologna, Italy

Franco Granella, MD
Parma, Italy

Arch Neurol. 1996;53(11):1093.

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Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.


"The treatment of chronic cluster headache is based on a few proven drugs, namely lithium salts, corticosteroids, methysergide maleate, and verapamil hydrochloride.1 However, some patients do not stop having attacks, despite treatment with 1 or more of these drugs. More recently, transdermal clonidine was proposed as a possible effective and safe treatment.2 This drug may act by reducing the sharp fluctuations of the sympathetic nervous system occurring during the attacks,3 by inhibiting the central sympathetic pathway. Tizanidine, an imidazoline derivative, usually used as a central muscle relaxant, is structurally similar to clonidine and seems to act through central 2-receptor agonistic activity.4 We treated 5 consecutive patients with chronic cluster headache resistant to previous treatments with tizanidine as add-on therapy. Results are summarized in the Table. In 3 patients the attacks ceased and any other treatment was discontinued, in 1 there was a marked reduction . . . [Full Text PDF of this Article]

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Joe

The full text image of the text is on the same page already linked to by Guiseppi:

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New transdermal stuff, another case report: Cherubino Di Lorenzo, Gianluca Coppola, and Francesco Pierelli: A case of cluster headache treated with rotigotine: Clinical and neurophysiological correlates. Cephalalgia. published 24 May 2013.
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I have tried just about everything. My clusterheadaches are probably caused by a neck injury but I am not absolutely positive. my mri shows narrowing in nerve canal at c4-5. on left side. tizanidine took 3 days to take effect and I am currently on 2mil 3x a day plus veripimil 180 a day plus I take antidepressants celexa and welbutrin. I have been cluster headach free since, but  I have to take it very easy. no heavy lifting. no freaking stressing out.  take it one day at a time. now it seems to me and most clheads that I have a different cause. probably true, but I have read that even a minor neck injury, one that most nuros may not consider bad at all still can cause cluster headaches. there called cervicojenic headaches and tizanidine is a drug used to help treat it along withother meds . just check it outif anything you will learn that there is more than one way to skin a cat right?

Just because clonidine and tizanidine are a2 adrenergic agonists - and have similar pharmacological action - does NOT mean that the benefits will be similar. Tizanidine is a potent muscle-relaxant, while clonidine is not (and, from my experience, has none whatsoever). 

Combining the tizanidine with the verapamil shouldn't be too much of an issue, other than that the verapamil will increase the Cmax of tizanidine somewhat significantly. However, combining verapamil with clonidine is NOT a good idea.

Tizanidine has, I believe, around 1/50 of the ability to lower blood pressure than that of clonidine. When I am out of cycle, I use clonidine for insomnia. However, it does seem to lower my BP by 10-20 points, and my HR by the same number. I'm by no means an expert on the matter, but I believe the two anti-hypertensives, taken together, would just be asking for trouble.

During a cycle, I'm more than happy to trade the wonderful sleep-inducing qualities of the clonidine for the relief I get from the verapamil.