Butalbital, (firoinal) was the only pain killer that ever helped my CH. That being said, there is a high potential for addiction, especially with a condition like CH which tends to get more severe with time. It should NOT be a frontline treatment. I haven't used butalbital since the early 1980's. There are so many more effective treatments out there now. Your best bet is a headache specialist neuro, with experience treating CH. If it turns out you have CH don't lose this website. It's the most comprehensive collection of knowledge on CH in the world.
I use a 3 pronged attack to treat my CH. I'm male, 51, a 33 year sufferer, episodic. Many use a similar program, although it seems everyone's is slightly different. Typical of the beast.
1: A good prevent med. A med I take daily, while on cycle, to reduce the number and intensity of my attacks. I use lithium, it blocks 60-70% of my attacks. Verapamil is the most common first line prevent, topomax also has a loyal following. Some have to combine lithium and verapamil together to get relief.
2: A transitional med. Most prevents will take up to 2 weeks to become effective. I go on a prednisone taper, from 80 mg to zero over a two week period to give me a break while my prevent builds up. Prednisone will provide up to 100% relief for many CH’ers but is harsh on the system and should only be used for short periods of time.
3: An abortive therapy, the attack starts, now what? Oxygen should be your first line abortive. Breathing pure 02 will abort an attack for me in less then 10 minutes, that’s completely pain free. Read this link as it must be used correctly or it will not work.
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Imitrex nasal spray and injectables are very effective abortives. I use the injectables, they’re expensive, and I rarely use them, mostly just when I get caught away from the oxygen. The pill form generally works too slow to be effective for CH’ers.
For now, get some energy drinks. Rock Star, Monster, any containing the combo of caffeine and taurine, chug it down as fast as you can when you feel an attack starting. Many can abort or at least really reduce an attack using these.
Finally there are the alternative methods for dealing with CH. They are outside of mainstream medicine but are providing relief for people when all else failed:
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Read everything you can on this board, if you are a CH’er, knowledge is your best ally. We’ll help you all we can.
Joe