Cluster Buster wrote on Aug 28th, 2009 at 3:11pm:LORAC Melatonin is not a sleeping pill won't induce sleep its best used if traveling jet lag take 3 hours before bed, I need something to knock me out so I not running on 30min-1:00. I tried Energy Drink, doesn't do a thing.
VAL Verapmil, how many people do you know who have or haven't responded to this medication? If it doesn't work do you have recommendation for next rough of preventative? My Soul is grown through this experience, I know that at least by April 2010 they will subside, thank god and god bless all those chronic Cluster suffers, make a vow to never take ones own life, and when everything you do and experience in life is associated with pain, its difficult to do. But its doing those things we don't want to do that makes us stronger. I think I'm going to get into MMA after I get my back fixed, my threshold for pain has grown immensely
!
Thant that doesn't kill me can only make us stronger
Cluster,
Of the 39% of the people who said that a preventative worked for them on a poll on this site, 7% said Verapamil was the best - but there is also much medical data supporting this is a good preventative.
I am a chronic clusterhead. Everything I do and experience is not associated with pain. It is a matter of how you look at things.
I have been on verapamil since almost the start of my ongoing cycle - and it does not prevent the hits, but prevents a good number of the Kip 9s and 10's... this is a big help in my opinion.
The other top preventatives to try after verap are lithium and topamax (now generic topiramate) - some use them together. verapamil and lithium is a wonder combo for some. Some need only one.
I wouldn't dismiss Lorac's idea about Melatonin right off - when I started taking it 10 mg per night 1/2 hr before bedtime, my night time cluster headaches almost disappeared. I now mostly deal with daytime headaches.
This is the article on Verapamil I was referring to that Bob usually posts...
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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