Posted by Bob Johnson (220.127.116.11) on November 29, 2000 at 10:32:13:
Quoting from Ninan T. Mathew, M.D., HANDBOOK OF HEADACHE.
"For episodic CH, ergotamine 1 mg twice a day is the first choice, followed by verapamil 360 to 480 mg a day. In more resistant cases a combination of ergotamine and verapamil is recommended. Methysergide 2 mg three to four times a day is an effective alternative, especially in younger patients. Methysergide should not be combined with ergotamine. Corticosteroids may be used for short periods to break the cycle of headache or to treat severe exacerbations.
"For chronic CH, the preference is a combination of verapamil and lithium. In more resistant cases of chronic CH, triple therapy using ergotamine, verapamil, and lithium, or using methysergide, verapamil and lithium may be considered.... Careful monitoring of blood levels of lithium...is essential."
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