CH wrote on Oct 26^th, 2009 at 11:24am:

Why?

First, I just found it odd that after two pages of responses, I saw no mention (maybe missed it) that FIRST you take prednisone, THEN follow up with Verapimil, not both at once. You take your burst or blast to stop the cycle, then follow up with a preventative to ensure it's been stopped. My specialist at the head pain institute which specializes in clusters was very adament about this. Never heard anyone taking both at once. Very well could be the problem. With that said, I too had no attacks while on prednisone. The very first day after the last tapered dose, and the start of the verapimil, I am back to at least 2-3 shadows a day and one mild attack, like a kip 4-7. Waiting for the verap to do it's thing. Only been three days now.

Well, I have to go with the majority then don't I? I am gonna have to check my paperwork, doses and such from the doc. Is it just the indomethacin I'm thinking of then? That I know for sure without checking was NOT to be taken while on prednisone. I was just so sure it was the verapimil too.

No offense taken. #1-don't join a big group of people on one board if your feelings are hurt easily. #2-Don't come to a place where we are all trying to help if you don't like "constructive critism". Anyhow, I still need to check the paperwork because now I'm curious if it was me or the doctor who put that in my head. More importantly, if what you say is true, would this maybe help with that inbetween period when the pred works great, then it all comes back until the full dosage is acheived with the verapimil? If so, I will very happily be wrong on this one.

this site is such a blessing, especially for someone like me who often has no ins therefore no real care from specialists. I go to the locak hospital er. Yesterday I was in the er and was introduced to th Dr " this guy is a real expert " which obviously I'm not but shows how little they know. I didn't know to ask for a preventative along with the pred taper, so I'll have to go back, what do you suggest? how much does it cost? BY THE WAY i SUFFERED FOR 10 PLUS YEARS BEFORE PREDNISONE WAS SUGGESTED ON THIS SITE

Like many on this board I have done a lot of research about available CH therapies.

Prednisone is a synthetic hormone of adrenal gland. One of its major characteristics is it that it suppresses inflammation and oedema (swellings) in general. The inflammation and swellings are  human body natural non-specific immune response to numerous attacking agents. It is speculated that high doses of prednisone given to the CH patients cause "shrinkage" of the tissues surrounding trigeminal nerve thus relieving the pressure on it.

Verapamil is a calcium channel blocker. The electrical signals propagate along nerves when specific ions permeate the cell membrane of a neuron. The most common ion species that causes electric signalling is single charged sodium ion. It is believed that the cluster headaches are associated with the abnormal electrical firing of neurons by calcium ion membrane penetration - "calcium channel". Verapamil blocks this penetration.

Both prednisone and verapamil have some serious side-effects and should be used with caution under physician's supervision. However, since their mechanisms of action are very different there is little to no interaction.

What makes cluster headaches such nasty animal is that there is no certainty of its cause. Theories range from simple mechanical explanations (blood vessel dilatation pinching the nerve) to the complex biochemistry of nerve conduction. That leaves us sufferers with "whatever works".


On the side note, Brew indeed emptied both barrels on Remission Lover but for the reason. What I really love about this place is that it did not escalate into flamewar. Remission rechecked her facts and gracefully admited she was wrong while Brew apologized for the strong language. The end result: we are all a bit more educated about the rationale for prednisone and verapamil therapies.

remission lover wrote on Dec 18^th, 2009 at 12:55pm:

thanks, verymuchI just did a new post... Are you a periodic? when do you your cycles hit, how many per day?

Were you takig the entire 100mg a day dose at once or spreading it out over the day? Whenever I'm on a pred taper my doc starts me at 100mg a day too, but 40 in the am, 30 at lunch and 30 at dinner. If you are taking the entre dose at once, it might be causing the headaches. I found that if I take more than 40mg at a time, I'm hit with a terrible headache. Hope this helps!!