I will be seeing a CH specialist in Ann Arbor Michigan in two weeks. My doctor states the patients he has sent there have had remarkable responses to the treatment regimens he recommended. I am just going for the consult as I have to pay it out of pocket since it is out of state and my ins doesn't cover it but my dr will follow with him for the treatment regimen after my consult and I have all my testing here.

He apparently has successful recent treatment regimens with Clomid. I am interested if anyone has actually tried this medicine. I have done a lot of searching on it already.

Gotta wonder about a fertility drug helping.

           Potter

Potter wrote on May 28^th, 2008 at 1:45pm:

Gotta wonder about a fertility drug helping.            Potter

I don't know - stranger things have happened, I guess.

 With child would be a headache.  

           Potter

         

I'm getting a bit old, and my memory may not be what it used to... but I remember someone on the old board mentioning Clomid..

--- Steve

I too remember reading some stuff on clomid and the uses for Cluster -  I remember looking into it because my first neuro suggested that my ch were related to estrogen.  I remember reading somewhere on this board something about clomid and its effectiveness for ch.  I googled back in march- and i remember thinking ' hmm, i might try that if this other stuff doesn't work'

so worth a shot to research it-  google and see what you come up with

kelly

I remember a study of some sort, where it seemed helpful for intractable chronics.

/ OK, this was bugging me, so I found it (on the old board). Actually, it was a chronic SUNCT patient.

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So, might it work on the dudes as well as the ladies?

Quote:

The patient is a 40-year-old gentleman who began to develop cluster headaches at the age of 21 years.The headaches started daily from onset and with no remission periods. The patient would experience between 4 and 8 cluster headaches per day. The headaches were 100% rightsided in a retro-orbital/periorbital distribution. On the side of the headache, the patient would develop eyelid ptosis, conjunctival injection, lacrimation, and nasal rhinorrhea.He would also become very agitated, pacing the floors or screaming out in pain. [...] Past preventive agents (all at top dosing schedules) included: valproic acid, methysergide, methylergonovine, verapamil, topiramate, lithium, gabapentin, baclofen, lamotrigine, mycophenolate mofetil, levetiracetam,oxcarbazepine,olanzapine, clonidine,melatonin, nimodipine, tizanidine, indomethacin, daily frovatriptan and naratriptan,daily DHE injections, mirtazapine, pregabalin, memantine, modafanil, ramelteon, as well as daily opiates. As short courses of corticosteroids would suppress his headaches, [...] The patient also tried a number of anesthesiologic procedures including: greater occipital nerve blockade, cervical facet blocks, selective C2 nerve blocks, C3 medial branch nerve blocks,sphenopalatine ganglion rhizotomy, and trigeminal nerve blocks, all without benefit. [...] Clomiphene citrate was started at 50 mg/day and the patient’s headaches decreased from daily to one headache 3-5 days per week.The dose was increased to 75 mg then 100 mg and his headaches became 80% improved with rare headaches 1 to 3 times per week. Source: Rozen T.: Clomiphene Citrate for Treatment Refractory Chronic Cluster Headache. Headache. Febr 2008; 48(2): 286-290, PMID 18070056. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

will be continued ...

Continued from previous posting:


Quote:

[…] Unfortunately, his insurance company would not cover the cost of the clomiphene citrate, so he had to stop the medication after 3 months of treatment. His headaches returned to daily, multiple headaches per day and he was placed back on daily injectable DHE, which he remained on for 18 months. [...] Eight months ago, the patient was placed back on clomiphene citrate 50 mg per day and after 2 weeks of treatment, he became pain-free and remains pain-free to this date. Source: Rozen T.: Clomiphene Citrate for Treatment Refractory Chronic Cluster Headache. Headache. Febr 2008; 48(2): 286-290, PMID 18070056. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

This almost sounds like a fairy tale to me but surely worth a try.

pf wishes and the best success with the trial!

I have. I dosed 50 mg for three months. Can't say that it did much. But it is worth a try. Dr. Mark Stillman has some studies on the use of testosterone replacement therapy in men as well as women.


Quote:

Headache. 2006 Jun;46(6):925-33.    Testosterone replacement therapy for treatment refractory cluster headache.    Stillman MJ.    Department of Neurology, Cleveland Clinic Foundation, 9500 Euclid Avenue, OH 44195, USA.    OBJECTIVES: To describe the clinical characteristics and laboratory findings of cluster headache patients whose headaches responded to testosterone replacement therapy. BACKGROUND: Current evidence points to hypothalamic dysfunction, with increased metabolic hyperactivity in the region of the suprachiasmatic nucleus, as being important in the genesis of cluster headaches. This is clinically borne out in the circadian and diurnal behavior of these headaches. For years it has been recognized that male cluster headache patients appear overmasculinized. Recent neuroendocrine and sleep studies now point to an association between gonadotropin and corticotropin levels and hypothalamically entrained pineal secretion of melatonin. RESULTS: Seven male and 2 female patients, seen between July 2004 and February 2005, and between the ages of 32 and 56, are reported with histories of treatment resistant cluster headaches accompanied by borderline low or low serum testosterone levels. The patients failed to respond to individually tailored medical regimens, including melatonin doses of 12 mg a day or higher, high flow oxygen, maximally tolerated verapamil, antiepileptic agents, and parenteral serotonin agonists. Seven of the 9 patients met 2004 International Classification for the Diagnosis of Headache criteria for chronic cluster headaches; the other 2 patients had episodic cluster headaches of several months duration. After neurological and physical examination all patients had laboratory investigations including fasting lipid

Don't forget that in women Clomid stimulated ovulation, so you may want to coordinate this with your OB/GYN. Good luck

Dr. Todd Rozen, MD is one of the top cluster headache specialist in the field of neurology.