Bryan wrote on May 3^rd, 2010 at 9:39pm:

     No.

        Potter

Since this is your first post, you have not been, I assume, reading just how often we write in opposition to the use of narcotics to treat CH. It has only one appropriate use--when all other meds have failed.

If a doc has given Fentanyl to you I should seriously question his knowledge/experience (unless you will provide a full history of your CH experience which might modify my judgment.)

We now have a range of safe, effective meds which, when used in appropriate combinations/doses give a high rate of success in controlling CH. I'd encourage you to read two articles which introduce standard treatments for CH.
========
 
Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (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]
====

and the PDF file, below.

Quote:


Most of the time it doesn't even do that.

Bryan, to sum up your question, just stick with the zomig and O2.  Bottom line, if your doc prescribed Fentanyl, he/she knows nothing about cluster headache then.

I have tried Verapamil, up 720mg, and am now on Topamax. After the first night attack is over, I can control them with the Zomig/O2. The first attack nothing seems to help. I have heard of drinking excessive amounts of water or vigorous excercise. But that is not possible while in the first attack because of the severity of the pain. Any other suggestions?

Have you tried melatonin for night hits??

USMCWIFE wrote on Mar 29^th, 2011 at 7:56pm:


Rozen is suggesting we can go upwards of 24mg to use as a preventative.
My magic numer was 9-12mg

USMCWIFE wrote on Mar 29^th, 2011 at 7:56pm:

If you're taking melatonin just to help you sleep, 1/2 mg. will work better than 3-5mg.  I know, sounds wrong, but it's well documented.

For C-H, about 10mg seems to work best for most - that's what I use in my preventive mix, and I'm pf for about 4 years now.

GL & Best regards,
Jim