I take verapamil.  I am currently on 120mg 4 times a day (total 480mg per day).  When I originally started on it, it was actually before I had CH and I was only taking 120mg or 240mg a day total - can't remember which.  Once I started having CH and was diagnosed, we took the verapamil all the way up to 960mg a day.  We first went up to 720mg pretty quickly - over about a week's time, I think - but then went up to 960mg later.  My CH's had always come at the same time every day - 5pm, 7pm, 9pm, 11pm, 2am, and 4am - but ever since we first took the verap to 720mg, I no longer have CH at any regular schedule.  This could be seen as a good or bad thing, but mostly I think it has been good.

Unfortunately, on the higher doses, my blood pressure got extremely low (60s/40s with pulse in the 40s), and I started having chest pains and vomiting, so we had to come down on the dose.  For awhile I went to the short-acting form at 480mg a day, and then I dropped it altogether for awhile.

Last summer, I started back on it, and I've been on 480mg a day ever since then.  I did have one abnormal EKG, but then we checked it again after a month, and it was normal, so we didn't have to adjust the dose - never knew if the abnormal EKG was from the verap or not.  The biggest side effects the verap causes for me is fatigue and swollen feet.  I don't have swollen feet all the time, but I get it periodically and it can be pretty bad.  I actually have to talk to my neuro about this next week because it's been happening more frequently.  The verapamil has reduced the amount of hits I had per day the majority of the time.

I had constipation from another med I'm on - and I'm not entirely sure if the verapamil made it worse or not.  What worked for me was taking Miralax once a day.  Miralax is now over the counter.  I recently had surgery, and once again the constipation was an issue, so I tried Miralax and colace, and it worked once again.  Once I got things more regular, the Miralax was able to be stopped.  I'm also on domperidone for GI issues, which aids in gastric motility, so I don't know if that has the added benefit of reducing constipation also.

At any rate - that's my story with verap.  I am a chronic CH'er for almost 5 years, and I've been on verapamil through most of it.  Due to the recent surgery I had, I'm hoping to start weaning off all headache meds over the next few months, but that's another story, and the decision only came about after years of prolonged suffering with clusters and chronic daily migraine without relief.

Would your doc consider adding lithium to the verapamil instead of simply switching from verap to lithium?  That works for a number of people here, and helped me for a little while, too!

Best of luck!
Carrie

-Chronic.
-Started at 360mg...no effect on the HA's...after two weeks went to 720
-At 720 my hits have gone from daily to a couple a week.
-I seem to have less energy than before and I would swear that my    memory is not what it use to be.
-Have not been able to avoid the side effects, but I can live with them because they are not as bad as the alternative
-I have been on 720 for at least 7-8 months
-no
-After reading bob's post I have considered getting an ekg
-I have never had any constipation with or without verapamil.

Best of luck and PFDAN.

MPMIII

- 7 yr’s chronic.
- Tried all that other crap and had no effect.
- verapamil, had no effect.
- O2 @ 25-40 Lpm can really help the stingers.
- Try the lithium! If it does not work you are out $25.00 for a 30 day supply.
- It cann’t hurt to try if you are truly chronic. Cheaper than a M tank refill.

Verap worked for me once, but other cycles it didn't do anything. I have horrible side effects from it - constipation (we all love that one), ankle/feet swelling, and worst of all it really, really messed with my vision.  So, no more for me!

Are you episodic or chronic? ........episodic

How fast did you raise the dosage? ....... in two weeks went from 480-660

How effective has it been for you and at what dosage? ......stopped my hits within days- still had shadows for a couple of  weeks - weak ones

Did it cause any side effects for you? ........extreme fatigue- could fall asleep sitting up, memory loss, lethargic, weight gain

Did you manage to avoid these side effects, most notably the constipation, and if so, how?...... no constipation at all

How long have you used it?....... i used it for 9 weeks- tapered off over a three week period

Are you worried about the possible long-term side effects, e.g. Verapamil causing heart problems? .........sort of-  i was so happy to be on it to stop the headaches i didn't care at the time, but the side effects for over two months really wore me down - so i was extremely happy to taper off.  Not sure about long terms side effects with short bouts of use-  I don't have any knowledge of that - so consumed with being pain free and trying to juggle my life    but i know i should!

And finally...if you get constipation from using Verapamil, what kind of food do you eat?....... n/a

hope this helps

So, one more question:

Those of you, who did get constipation...or who did get tired:

Did you notice that those side effects lessened or disappeared over time, e.g. in the span of days or weeks?

- Rosa

Side effects for me were mainly dizziness and sleepiness.  I couldn't take a yoga class without almost passing out several times.

I have IBS so the gastrointestinal effect of verapamil was a benefit to me 

This past cycle I switched from the extended release formulation of Verapamil to the regular release formulation.  Using 40mg steps I was able to titrate up more slowly and fine tune the max dosage as needed.

While I was only able to tollerate 240mg of the extended release.  I got to a theraputic dossage of 400mg of the regular release.  It did the trick and eliminated 90% of my hits.

-Dennis-