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hello (Read 553 times)
WEEDKILLA
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hello
Jun 16th, 2009 at 3:38pm
 
hi all my names andy been suffering for over 6 years now but was only diagnosed 9 months ago im on 480mg verapamil per day and sumatripan sprays but they are only the 10mg ones some days i get them 8-10 times and they are very bad im only 28 and struggle with work and a daughter thats in her terrible twos Sad
viva la cure
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Bob Johnson
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Re: hello
Reply #1 - Jun 16th, 2009 at 3:47pm
 
Unless your doc has plans to increase your dose of Verap, it's too low for most CH folks. This is a widely used protocol written by one of the better headache docs.
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Headache. 2004 Nov;44(10):1013-8.   

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.

    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).
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Bob Johnson
 
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WEEDKILLA
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Re: hello
Reply #2 - Jun 16th, 2009 at 4:51pm
 
thanks for the help bob he said any more than 480 and i had to get a ecg scan this would explain why mine get so bad. After years of them that was the 1st doctor to properly diagnose them one said the pain was sinus troubles and others said migrains i wish it was something as less painfull as that  Cry mine are all about kip 9
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kevmd
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Re: hello
Reply #3 - Jun 16th, 2009 at 10:56pm
 
480 may work for some but it is on the low side.  Verap can be dangeous if you take too much which is why an EKG is not a bad idea before increasing your dose.  Ask about o2, your life will improve immensley
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PHILADELPHIA PHILLIES 2008 WORLD CHAMPS
 
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