Posted by DocGreg on December 02, 1998 at 23:21:59:
In Reply to: Re: Rebound Headaches posted by Jackie on December 02, 1998 at 18:04:59:
J,
The major effect of prednisone is as an anti-inflamitory. Inflamation is caused by the body's immune system fighting something. What in cluster headaches is being fought???? I don't know. Some people here think it may be fungal (possible, and would be great if true as this would be fixable), possibly some allergic reaction, nerve irritation from some unknown source...yet to be discovered.
When you take prednisone, it inhibits the body's ability to become inflamed (a process used in killing germs, etc). The high doses knock it down fast, and often takes care of the headaches. The reason for the taper is not to gradually step away from the inflamation, rather the body begins to expect the presence of the prednisone and stops making our own natural steroids. The slow wean gives our body the chance to start making it's own steroid over again.
But, after the high doses of prednisone are gone, sometimes the inflamation returns (as the underlying event/irritant is not gone). Why? Don't know.
So if that irritant persists, either long term steroids are required, or removal of that irritant is required.
For some reason, clusters often resolve after one week of high dose prednisone (apparently, the actual trigger disappears and it's just the bodies reaction that keeps it going). But, unfortunately, this is not always true.
I know this sounds like a round about answer, but that's the best I can do for you.
Good luck
Greg