So, after some significant pain free time time (5 months) - i was hit again in March. 
.
Previous regimens of multiple drugs (Verap, Verap+ multiple other things) had failed during the last cycle.  What did work was this suggestion by my neuro:
.
1 spray of migranal in each nostril morning and night.  I did this for about a month, and the cycle went a way.
.
I've been doing this since March, it costs me 10$ month for the migranal (now it's generic) to be able to do this... and I've not had one hit since March.
.
I know migranal is not a maintenance drug - does anyone have any comments about this method of staying pf?

The usual preventive meds. PDF file, below.

---

New one on me, but then at one time oxygen and D-3 were new to me! Hoping it continues to do the trick.

Joe

Migranal is 'DHE-45' in a nasal spray. DHE IV treatments (in a hospital setting) is / was often used to try to break a cluster cycle (Sometimes successful, sometimes not).

Either way you get it, it's still DHE. Side effects can vary from mild to fatal. DHE can (and probably will with long term use) cause heart valve scarring and/or other heart related problems.

My main point is that it is a powerful vasoconstrictor and you should be careful with the use of this med, follow your doctor's advice, report side effects to your doctor, and read up on contradictions (such as 'Do NOT use with any Triptan drugs...', etc.).

I've taken Migranol, and DHE in every other form (SubQ, IM, and IV). I still take a DHE IM injection nightly to prevent waking up to a fight with the beast.

Glad it has helped you. I hope it continues to help you without major side effects. The less you need to take, the better.

Good Luck

I4B

Thanks for the info.  I have not noticed any side effects at all - and I've been on the 2 sprays in the nose morning and evening for a few months.
.
Certainly I've had more side effects on any other drug I've taken including verap. 
.
The heart valve caution worries me though, perhaps that is a side effect I won't feel until it's too late?

I love migranal, but it's been a last ditch go-to for me because it's expensive. You say it's now generic? Do you have the generic name because all I know is the brand name Migranal. Sounds like an interesting plan I'll discuss with my headache neuro if what I'm doing right now doesn't work. Thanks for the post. Blessings. lance

The generic name is Dihydroergotamine-45 nasal spray.

Yeah, I went to the pharmacy about 2 months ago and they told me it was $600 dollars for one box.  I found out my insurance stopped paying b/c the generic came out.  $5 bucks.
.

Dihydroergotamine Mesylate cost my insurance approx. $6,754 per month for 60 injections (One 1mg injection every 12 hours as needed for Cluster headaches). There are 5 (1mg) glass vial doses per box.

Pretty expensive stuff. Pretty nasty med too.

I4B

Ah injects... I just use the nasal spray.  I'm now weaning off to see if my cycle is busted..this is about how long it took last time.

Joshua, I was interested in your Migranal usage as a preventative, so I asked my headache specialist what he thought. Short of is, he thought within reason (don't mix with imitrex) it would be worth a try. Haven't had to resort to it yet (I'm coming down from a methylprednisone dosepak) but I will. I'll let all ya'll know how it works. God bless. lance

I apologize for the late add on; however, I am having difficulty locating DHE 45 at the moment. Target Pharmacy, Walgreens, Rite Aid, and CVS do not have the drug in my area (Suburbs of Baltimore). This is an add on prescription for me, a last ditch effort of sorts, and it seems everywhere has the drug on back order. Is anyone else experiencing this problem? Does everyone else order this online? Thank you in advance- I am getting frustrated trying to find this medication.

@BSBAQE12  - I go to a Walgreens and they had to special order it, but now they get it regular b/c I refill it.  The box says:
"Dihydroergotamine Mesylate, USP.  Nasal Spray" - made by Oceanside Pharma.  I do not order online, I go to a local pharmacy. 
.
UPDATE: 4 days off the Migranal, no more headaches so far.  This was the same pattern as last time.  1 spray each nostril morning and night for about 3 months.  No other meds.  - I don't love taking it given the possible side effects, but it's just so low maintenance and I haven't noticed any ill effects. 
.
Who knows when it will stop working, but for now this is my bullet.

Thank you for the quick reply. I will have to see if walgreens is capable of ordering the medication here. Target cannot and states it is back ordered at all local locations. I here as a last ditch effort, that this drug works wonders, if I can locate it, we shall see.

Walgreens and other pharmacy's around here won't even order it for me. I have to get my from a KROGER's pharmacy now.