Posted by Stanley (163.179.204.54) on December 15, 1999 at 08:34:54:
I am a 30 year sufferer of episodic cluster headaches. Each episode lasted about 6 weeks, occurring every 18-24 months.After several failed trials with many medications and their associated side effects I found that Varapamil 360mg per day would shorten the attack, but as others have mentioned it took 2-3 weeks to build up to an effective blood level. In the interim I would suffer with 1-3 attacks per day until the miracle of Imitrex injection. This has been my saviour. However this time around my attack has already lasted over 5 months and has changed it's character. Initially it occurred daily, being aborted by Imitrex injection, until Verapamil became effective after 2 weeks at a dose of 360mg. No futher headaches for 3 weeks and then they came back again. My dose of Verapamil was increased to 480mg and the headaches persisted at 1-3 per day, thankfully being stopped by the Imitrex each time. The Verapamil was increased to 600mg per day with fatigue and constipation++. (Psyllium has helped that.) The headaches stopped for 3 weeks and my dose of Verapamil was then slowly tappered by 120mg per 10 days. 4 days after starting 360mg/day the monster returned and the dose was gradually increased again to 600mg/day. The headaches changed from daily to a cycle of 3-7 days without headache and the 3-5 days with 1-3 attacks per day. All this time aborting the pain with Imitrex. Trying desperately to prevent this from taking over my life I have even been able to give myself a shot into my abdominal wall while at a movie. I then had an ECG to make sure my cardiac conduction had not been affected by the high dose of Verapamil, and when this was OK was placed on 720mg/day. After a few days my body seems to have adjusted to this dose. Had no headaches 4 days later and then they recurred. When will this end ??? Unfortunately I cannot tolerate Steroids,Sansert,Depakote,Lithium. Oxygen and nasal Lidocaine didn't do it for me. My fear is that the Verapamil no longer works and that I may have changed to a chronic cluster pattern. Oh well at least I have Imitrex injection that works ( except for 1 time). Has anybody else had an experience of Verapmil loosing it's effectiveness?