Can Verapamil actually terminate an episode or does it just ease the load?

Trevor wrote, Can Verapamil actually terminate an episode or does it just ease the load?

Verapamil is used as a preventative in the treatment of CH's so it won't terminate an episode. If you are a CCH sufferer then you need to stay on it, as for episodic, after you've run your cycle, wait a couple of weeks and you can stop taking it.

Have you looked into the vitamin D regimen on here as a preventative?

Hoppy

Thank you for the info. 20 years now and I thought I was over it at my age. No such luck. Atleast the episodes are now 4 years apart but last around 6 months. This is the second time I have tried Verapamil and this time it has had a positive affect so will keep on with it and see how it goes.
No, I have not tried the Vit. D thing. Thanks again!

If your cycles are 4-yrs apart, I assume you are saying that the interval has growin longer as you have aged.

If that's the case, I'd not bother changng anything you are doing now. Use the Veap when a cyhcle starts, coninue it for one month, or longer if you cautious, using whatever abortive workds for you.

If you have a simple routine which works, stick with it; save the new drills for the kids!

Thanks Bob. Yes, the intervals have grown longer. Started at 2, then 3 and for the last two epidoses, 4 years apart with episodes lasting roughly 3 months, then 4 months and the last two around 5 to 6 months.
Pete Batcheller very kindly sent me a lot of info on the D3 regime yesterday. Once I have looked through it all I may give that a try.
The Verapamil has definitely made a difference but it is early days in this episode so we shall see. Things tend to work for awhile then stop. The shadows are quicker to go with O2 and the hard hits where I resort to injections are less frequent but I am under no illusions. This could change in an instant. I feel so sorry for all who suffer from this but the worst by far are the young folk that are affected and it seems as though their numbers are increasing. Oh for a legitimate cure!

Trevor, the timing of your ch sounds familiar.  When i hit 40 years old my cycles started to get farther apart but also got longer.  My last cycle, at age 55, lasted 6 months.  That was ten years ago now.  I sure I've outlasted them!  Here's wishing you the same.

If the Veap isn't giving you sufficient relief then consider increasing the dose. Such adjustments are not unusual from cycle to cycle.

Given the long intervals between your cycles it makes sense to me to keep your treatment program simple.

For a few years before I aged out of having attacks, I discovered this approach: rapid acting on attacks ; some potential for totallyl ending attacks; inexpensive.
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Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.


Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Thank you all for the input.
The Verapamil seems to be doing OK. Still getting shadows 4 or 5 times a day but seem to be a lesser variety and O2 gets them stopped very fast. 90% of them as a wake up from sleep. I have not had Sumartriptan pills (as a preventative) nor injections (as an abort) for a few days now so hopefully this will continue for the episode duration. Pretty easy to handle like this. Upped the Verapamil to 3 x 240mg.SR a day and will keep this up. I will have a look at the Olanzapine as it sounds like a good fallback. Thank you all.

Touch of misunderstanding in your last msg.

Sumi. is an abortive, to kill an active attack--not used to prevent attacks. It's life is too short to serve as a long term preventive.

Verap. is used daily, builds up in you body to a steady state, and then prevents (one hopes!) attacks from developing. You keep adjusting the dose upward until it is effective in reducing/stopping attacks. So, you stay on Verap as long as it seems you're having attacks. No problem using it 100% of the time if you have short cycles of attacks. Whole goal  is to prevent or blunt attacks.

Look over the article, below, it will help make clear what the purpose is for the variety of meds we have.

It a useful piece to guide discussions with you doc.

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Trevor wrote on Jul 4^th, 2016 at 1:00am:

Can Verapamil actually terminate an episode or does it just ease the load?

Im chronic, badly, and verapamil put me into a good remission for a while when i first start on a dose, started at 240 and didnt get an attack for almost 2 months, then it was on and off for a year, but way better then the pervious 3 years of getting multiple attacks everyday. And even when it failed a year later it still kept the intensity down. Then i went up to 360 and again went into remission for a period of time, then i had good weeks and bad weeks, and then again it failed 1 year later almost exaclty to the day, then we went to 480, didnt work, so he put me on 720 and again i went back to doing well again, good to me is hell to a normal person lol, but its better then nothing. Even now the 720 failed, the attacks are back and I have zero quality of life, but if i stopped taking it things would get dramatically worse. It sucks its like im chained to this pill. But like I said atleast for me it keeps the intensity down, Back before I started on verapamil id regurally get hits kip 7 and up,I suffered for about 3 years before starting the verap, and since being on it, about 4 years now ive only had maybe 20 hits above a 7, so for whatever reason even when its failed like now it keeps the intensity down, but not the frequency or duration.

Ive also heard verap can make eposidic suffers go chronic, but my neuro said thats bs, its just the nature of our disease and how it progresses over time, regardless of the verap that person would have gone chronic etc. But he could be wrong, I find these docs to be wrong alot when it comes to CH, they know as much about them as many of us do, nobodies doing resreach, we dont have one single FDA approved drug for the treatment. The only people researching is an italian group, besides them theres noone.

verapamil keeps showing up on here, is it the standard go to for ch now? i had been well controlled on topomax for the last 3 years but it looks like i need to find something new. 3 years ago it seemed like it was a free for all of trying drugs and weighing side effects

Hi JC,
Verapamil is the go too preventative @ 360-480mg/day, but lots of folk here are on the vitamin D regimen as a preventative which has 80% of them less intensity and 60%  pain free. Myself included.

Cheers Hoppy

thanks hoppy. i took 10000 sat and 50000 today (missed the loading part first read) but all i took was the d3, i will get the rest of the supplements monday. ive got more questions on it but want to read more in case its already answered and ask on a vitamin d post and not hi-jack this one.

JC, highjacking is allowed here  [smiley=lolk.gif].

Hoppy

Just some clarification re Bob Johnson's post: Bob, When I said that I use the sumi pills as a preventative, I meant I took them proactively as I sometimes get 7 to 8 hits a day so it helped control the pain when the hits came. It certainly did not stop them from visiting.

So far the Verapamil has really helped. Only one shadow in the last three days - no pills and no injections. Here's hoping that it keeps doing it's thing for the next 5 months!