I have had Episodic Cluster Headaches for about 10 years now. I am 63 year old male. I know the drill. Typically one attack per year. Altitude (although sadly I love the mountains altitude is a trigger) and high-stress are both triggers for me. I am usually too slow to respond with treatment, and wait till the pain level is 6 to 8 before I start any kind of serious medications. When will I ever learn? Pure O2 and Ice bring relief. I also now have the Sumavel 6mg injections which seem to stop an attack if needed. Reluctantly, I start the Steroids (hating the side effects) 60mg (20mg, 3x/day) for 7 to 12 days and then taper. Along with the Prednisone, I take Verapamil as much as 480mg/ day parsed out through the day. Ambien to sleep. Sometimes the Doc puts me on Depakote and Trazadone depending on the severity of the episode and my response to the meds. I've even tried Cannibinoids, and cannabis topical creams (with some success) to deal with the pain. I just started Neurofeedback to try and tame these beasts. But that's not my question.

I want to ask if anyone has had lingering headaches and also vertigo attacks AFTER an episode, after the treatments, the medications? This year my CH episode lasted 3 months. I am finally at the tail-end (after 30 days of steroids, 3 occipital nerve block injections) and a month of Verapamil 80mg/4x/day. I no longer wake up in the middle of the night with a CH, I no longer have CH attacks. But the doc kept me on Verapamil to really snuff out this series. I just completed a one-week taper OFF of Verapamil. But now every morning I wake up feeling rested and feeling good (although I do often wake up with a small morning headache since I have mild sleep apnea) but then by the afternoon, I have a headache (not CH) rather a regular headache #1 on the pain scale that is treatable with Excedrin or Aleve. However, even more disruptive is by late afternoon/evening I get vertigo/dizziness. Whether I am in a noisy restaurant or even watching just TV I get dizzy and nauseous. I go to bed and I am fine. Ive had vertigo off and on for over a year now, prior to this episode. But right now, possibly because of all the drugs Ive been taking, the vertigo has kicked in again.

My hope is that these lingering headaches and espeically the vertigo attacks are a reaction from the length and severity of this CH episode and the huge amount of drugs (most recently 320mg/day Verapamil for a month) that I have taken over the duration. I've been on Ambien CR 12.5/night for 3 months now. Can Ambien cause vertigo and headaches? I am depressed about the vertigo and the lingering headaches and the length of this entire episode (September - December.) This seems to be too long this time. The good news, is that the times that I feel good are more frequent. But the lingering headaches and the vertigo are depressing me. I worry that maybe I have something worse than the headaches. I have had 2 MRI brain scans over the past 10 years which have been evaluated as normal. Has anyone ever experienced a post-CH-episode lingering headache or vertigo? Will this episode ever end? 

strobes wrote on Dec 24^th, 2013 at 11:34am:


That is a long time to be on steroids. A "normal" prednisione taper dose with CH is typically around 10 days or so. Long term use can result in serious issues (Google will find lots of stuff for you on this).

Also a week to taper off verapamil from a high dose is pretty quick too. I'd normally drop the dose by about 80 or 120mg each week, so possibly taking 3-4 weeks or so to drop down from 360 or 480mg a day. Remember that verapamil will also impact things like blood pressure, so too sudden a change can cause issues elsewhere.

Lingering headaches and vertigo attacks are not commonly reported with post CH episodes, although there is a chance that the rapid taper off verapamil is causing blood pressure issues. Do discuss this with your doctor. It is possible that there is a non-CH cause that needs to be investigated.

It is also possible for you to have another headache type too (I also get migraines) and some of the headache symptoms like it improving when you go to bed could be a sign of migraines too but this is something you need a doctor to work through and give a diagnosis.

Another possibility is that you're also getting rebound headaches with the frequent pain killer use. Generally using pain killers more than 3 days a week is likely to result in rebound headaches. Of course it isn't easy just cutting back on their use when you're in pain (I know, I've had to do it too), but looking back through my headache diary I can see that doing so had a drastic impact on my headaches that was well worth the initial pain I had to go through to get there.

As Bob said, this is something you need to discuss with your doctors so they can make an accurate diagnosis for you.

Okay so 3 weeks later, the clusters are gone, and the continuing headaches are also outta here. No need for drugs nor Oxygen, nor Ice. This was a long time to be in a cycle. Beginning to end, this episode dragged on from the end of September till the middle of January. That said, let me say that I suspect that the ongoing headache problem was caused by the continuing use of Ambien CR 12.5 and Verapamil. I took the initiative my self to taper off of both of these. I rarely need an Aleve any more. The Disease is terrible I know, I've had it 10+ years. But those damn drugs also wreak havoc on my poor body. Now I also agree with Bob Johnston, that my Vertigo was/is a totally unrelated problem (perhaps caused by the drugs themselves) In any case the Meclizine works well to treat the occasional vertigo attack. Promethazine works for vertigo too. Now I am looking for cures. I am even trying neurofeedback.