I'm 43 and I cycle about every 18 months to 3 years. Cycles last 2 to 3 months, taper up then back down. Done all the drugs, used O2 with success, have good relationship with doc/he gives me whatever I want....What I'm looking for is a plan of attack. Is there someone out there similar to me with something written out....Here is what I basically do: use O2 and over the counter pain relievers in the beginning, use O2  and triptipans when they get worse, 9 weeks in I cry and start to look to new drugs or drugs I have not used before. I feel as though I'm in the beginning stages of a cycle right now.

Hi Alex.Jim and Welcome

Given that your cycle is fairly short you may want to ask your doc about using a Prednisone taper to try to kick the cycle.


Quote:

Prednisone For the episodic form of cluster headache, prednisone is highly effective in over 75 percent of patients (Kudrow, 1978) (Table 6-3).  The value of prednisone has been established in a double-blind study (Jammes, 1975), and it is clearly a first-line drug, if not the drug of choice in this situation.  The dosage has varied from 10 to 80 mg daily in various studies (Couch and Ziegler, 1978).  I use 80 mg per day for 7 days and then rapidly taper the dosage over 6 days.  Pain paroxysms usually cease within hours for the first dose.  If there is no response after 48 hours, prednisone should be stopped and an alternative therapy instituted.  If, while the dosage is being tapered, headaches return, prednisone may need to be continued for the duration of the cycle, preferably on an every other day basis, at dosages less than 140 mg weekly.   Many patients have to take prednisone for 5 or 6 days, but then stop it and find that the bout is over.  This has happened often enough to convince me that prednisone can actually terminate the bout for about 20 percent of patients.  Watson and Evans (1987) made similar observations in 2 of 11 steroid-treated patients with the chronic form of the disorder.  It is, therefore, worth treating the chronic patients with a 2-week course of corticosteroid, with the aim of interrupting the cycle, although in most headaches return when the dosage is tapered. I have seen several patients who were unresponsive to full dosages of prednisone, but who responded spectacularly to triamcinolone at dosages of 32 mg per day. The remarkable efficacy of corticosteroids in this syndrome is not easily explained.  McEwen et al, (1986) have reviewed the many potent actions of the corticosteroids on the CNS, but these are just beginning to be defined.  De Kloet et al (1986) studied the relationship of corticosteroids to the serotonergic projection from the dorsal raphe nucleus to the hippocampus in rat brain; they found that corticosteroids exerted tonic control on serotonergic neurotransmission in this system.

Wishing you PF Days and Nights!
Ging...

Read these articles and give us some idea whether they are useful to you.

PDF below.
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Cluster headache.
From: START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]

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I'm 50, and have used the following recipe to tame the beast, it's 32 years of trial and error!

Cycle starts, a 2 week prednisone taper while I start up my prevent, lithium. Over a week I build up to 1200 mg a day, at that level I'll block 60-70% of my hits. That's my prevent regimen. Although I'll add I stop drinking alcohol, try and be real careful about screwing up sleep cycles, avoid prolonged stress and don't let my self get really hungry...all triggers for me.

For attacks, first choice is the 02, then imitrex shots. I drink an energy drink while I'm aborting with 02 as it seems to speed the abort and reduces my come backer attacks.

JOe

That's a good plan, Joe. My plan is nearly the same, but with Verapamil instead of Lithium. I also take 15mgs of melatonin nightly, with a Super B complex every morning. And O2, nearby and always! blessings. lance

Good point Lance...the supplements people take. I was told by a neuro long ago to take Vitamin B-2 and Magnesium daily, as migrainers were supposedly low on both, and he was convinced there was a tie in to migrains.

More recently a rather respected member of this board has been working with a theory in which altering your arterial PH, will make you less succpetible to attacks. Not a cure by any means but a way to reduce attacks. He advocates the following regimen up to 4 X a day. Magnesium, Calcium Citrate with Vitamin D and Zinc, washed down with a glass of peferably fresh lemonade.

So my 1X daily supplement in or out of cycle is B-2, Magnesium, Zinc, Calcium Citrate with Vitamin D, and a daily vitamin with iron. When I hit a high cycle I run Batch's routine 2-3 X a day. Seemed to help me thru a tough cycle this past go round.

Joe