Hey AHJ,
Welcome to CH.com. You've come to the right place. We know what you're going through and the good news is it doesn't need to be that way.
You were likely given a prednisone taper. It should be effective in preventing your CH but only for the duration of the taper... usually ten days to two weeks. After that the prednisone side effects become onerous.
During the pred taper, most neurologists who are familiar with the standards of care in treating patients with CH, will prescribe verapamil as a longer term CH preventative.
When you see the doctor who prescribed your CH medications, ask for a prescription for home oxygen therapy at 15 liters/minute with a non-rebreathing mask. Oxygen therapy can be a very effective and safe CH abortive if used properly and started early at the first sign of an approaching CH attack.
You also need to ask for the 25(OH)D lab test. 25(OH)D is the serum level metabolite of vitamin D3 that's used to measure its status. The normal reference range for serum 25(OH)D is 30 to 100 ng/mL.
Unfortunately too many physicians will interpret a 25(OH)D lab result of 31 ng/mL as normal... nothing could be farther from the truth with cluster headache... You need to keep your 25(OH)D serum concentration up around 80 ng/mL to prevent your CH. That will require a vitamin D3 intake of 10,000 IU/day plus the vitamin D3 cofactors and Omega-3 fish oil. This is the anti-inflammatory regimen and to be effective in preventing your CH, you need to take all the listed supplements.
If there's going to be any delay in obtaining the 25(OH)D lab test or you get push-back from your neurologist, start the anti-inflammatory regimen now. The odds are you're vitamin D3 deficient and that deficiency is contributing to your CH.
At 30 to 50 cents a day, depending on where you buy your supplements, the anti-inflammatory regimen is the most cost effective and safest CH preventative available to us. You can read all about it at the following links:
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This regimen should help calm your anxiety attacks to the point you can drop the Xanax and it may even help with your OCD. Check your PM inbox, I've sent you some additional information.
Take care and please keep us posted.
V/R, Batch