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        New Message Board Archives >> 2005 Cluster Headache Specific Posts >> The Madness is BACK!
        
(Message started by: nancyc on Jul 4^th, 2005, 1:13pm)

Title: The Madness is BACK!
Post by nancyc on Jul 4^th, 2005, 1:13pm

AFter two years of almost being pf...except for a few breakthru periods that did not last long....I am getting slammed.....I am still on the duragesic patch for my back and my chs, topamax 100mg....and started on verapamil again nite before last ...I started the verap on my own....Guess I will go see my neuro again this week sometimes. I had been getting hit for the last month on and off but nothing like this.....I am getting hit about 4 to 5 times a day. The humidity is really bad here and my stress level is off the chart so maybe this has something to do with it...who the hell knows.....Could someone give me a reminder on how to do the verap again? I have the short acting kind...I am taking 160mg in the morning and 80 at nite so far and nothing is changing.....my pulse rate is 112... smiles, nancyc

Title: Re: The Madness is BACK!
Post by Bob_Johnson on Jul 4^th, 2005, 2:24pm

: Headache. 2004 Nov;44(10):1013-8.

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.

Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).

Title: Re: The Madness is BACK!
Post by unsolved1 on Jul 4^th, 2005, 2:26pm

Sorry you're getting slammed right now. I hope you get some relief soon.

RE: verapamil ... your doctor should be the one to tell you how much to take. Too much Verapamil can dangerously lower your blood pressure.

Good Luck,

Unsolved

Title: Re: The Madness is BACK!
Post by Ree on Jul 5^th, 2005, 1:31pm

sorry Nancy C.... you be well.... awaiting Daves cycle.... Ree

Title: Re: The Madness is BACK!
Post by sandie99 on Jul 5^th, 2005, 1:43pm

on 07/04/05 at 14:26:26, unsolved1 wrote:

RE: verapamil ... your doctor should be the one to tell you how much to take. Too much Verapamil can dangerously lower your blood pressure.

True. Mine was low before the treatment started and the result was: I fainted on several occasions. Be careful, okay?

Wishing you PF time,
Sanna/sandie99

Title: Re: The Madness is BACK!
Post by Karla on Jul 5^th, 2005, 10:32pm

Sorry to hear your getting slammed hard still and having to take so much trex. i to have also for the last week the beast has broken through the patch and been giving me grief.

Title: Re: The Madness is BACK!
Post by Kim Y. on Jul 5^th, 2005, 11:51pm

NancyC and Karla PF wishes and vibes out to you both... Be strong and beat the beast to bloody pulp k... [smiley=hug.gif]

Title: Re: The Madness is BACK!
Post by nancyc on Jul 6^th, 2005, 1:31pm

Karla, what is going on...could it be this humidity? this has not been this bad in over two years...the patch has always pretty much worked...i am on 50 mcg....going to see my doc tomorrow afternoon....i cant take this anymore...getting slammed 5 times a day now and the hits are so severe...feels like a blood vessel in my temple is about to burst.....it is scaring me so much...nancyc