Hi Todd
One thing you can be sure of is nothing stays the same.
I have had 5 previous cycles I can remember and am currently in my 6th.
Everyone has been different. Currently I get hit at 10.30pm on the dot but I remember previous cycles being wake up calls at 2.30am and other cycles being 5.30pm hits. Also although the hits can be like clockwork, I've also had individual hits at completely random times that don't get repeated. This cycle my hits average between 30-40 minutes but I have had them last 90 minutes (torture !)
Also my responses to medications have been different. Last cycle i was able to control it with a Pred taper and 240mg/day of verapamil, this cycle I'm on 480mg/day but still not pain free, go figure !
I suppose the advice will be to stay flexible in your response and don't be afraid to change or tweak your treatment as required.
Good luck and I hope you get a handle on it soon.

All the best
Alan

Frustrating to have such irregular, brief periods of attacks. It's makes it useless to use the usual prevention meds.

Talk to your doc about using this med (below) when you have an attack. It has several advantages:
1. quick action
2. inexpensive compared to the usual abortives. I fact, so cheap on a per dose basis and you need so infreqent, that you could buy out of pocked, in small quantitles, without having to consider insurance coverage.
3. Bein a pill, easy to carry withyou.

When I discovered it, it became the only med I used.
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Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.


Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.