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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> verpapamil
        
(Message started by: gardengal on Feb 24^th, 2006, 6:23pm)

Title: verpapamil
Post by gardengal on Feb 24^th, 2006, 6:23pm

I have been on 240 ER verp. for 5 weeks and have been having clusters for 8 weeks. They have always been over in 2-4 weeks before. I have an obnoxious ache every night,it doesn't get bad,but have to take a $16 relpax @ night so I can sleep. Should I up my verpapamil? Should I be having no pain at all?I think taking the verp. is making tham last longer. Should I taper off and just suffer? I am afraid of going for months. I was in remisson for over 8 years. I am so depressed that they are back. I quit smoking 9 yrs. ago and had 2 or 3 more attacks and then OK for 8 yrs. So don't tell me that smoking doesn't affect them Then I was so stupid to smoke at parties for the last 2 yrs. I went out about twice a month and they are back. I haven't smoked since they started on Jan 7th and i still have HA. I wish I knew what started these. But I regress. Your opinion about verp. prolonging ha? thanks

Title: Re: verpapamil
Post by Kris_in_SJ on Feb 24^th, 2006, 7:59pm

Hi Gardengal,

I'm a garden type of gal too.

With regard to the Verapamil ... I've never found relief or a decrease in intensity or duration of the beast until I reach 480mg/day. There is also some belief that the extended release can be less effective than the regular- though I haven't noticed any difference. It's the higher dose that seems to help, and many here go much higher than 480/day.

In terms of whether or not Verapamil extends your cycles, I would have to say "probably." However, once it truly kicks in, I'm usually reduced to shadows for a couple weeks, then they're gone. Where I've had trouble is in weaning off. My cycles are pretty far apart, and I refuse to take drugs between them. The last time, it took me 5 months to slowly wean totally off the Verap without the return of shadows or twinges. It can be done though! Now 1 1/2 years drug-free. PM if you have questions or need support. Meantime, get that dose increased!

Hugs,

Kris

Title: Re: verpapamil
Post by burnt-toast on Feb 25^th, 2006, 12:38pm

1200mg Lithium, 720mg Verapamil, 9mg Melatonin 30-45 min. before bed provided me with relief - not perfect but sufficient relief to be somewhat normal via a significant reduction in attacks. From these base meds. I have experimented/tracked the effectiveness of other treatment options with great success.

I have just recently gone into a remission after more than three years of chronic attacks. (Knocking wood)

Getting to/understanding at what levels these meds. were most effective took effort. A headache journal and careful tracking combined with establishing options review/discussions during every visit with my Neuro. were critical.

For me 240mg of Verapamil was useless - 480mg produced results, 720mg gave reasonable relief, 960mg started producing a lot of side effects.

Keep a journal, work closely with your docs., experiment and track your results - go with what is proven to work best for you.

Tom

Title: Re: verpapamil
Post by PL259 on Feb 25^th, 2006, 5:59pm

Since I don't have a real doctor anymore, just one that writes my 360 mg a day verap I don't know about increasing the dosage. I usually have to con him into a prednisone burst to get any results. Maybe I will find a real doc one day, but not here in "hick" country. Some people get off the verapamil when out of cycle, I have to stay on it constantly or have wild and unpredictable cycles.
Good luck with it.

Title: Re: verpapamil
Post by Bob_Johnson on Feb 25^th, 2006, 8:53pm

: 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: verpapamil
Post by Karla on Feb 25^th, 2006, 11:12pm

You can try up to 960mg of verapamil(calan) and /or 900mg lithium. It has done wonders for many.

I had side effects and couldn't tollerate the verapamil and the lithium by itself cut my number of ha in half that I was having. It worked for two years then quit working on me. >:(

Good luck in finding something that works!!

Title: Re: verpapamil
Post by pfunk on Feb 28^th, 2006, 1:12am

Yeah, I think I'd probably ak the doc to uo the doseage of verap. I started at 360 a day but am going up to 720. It wil be 180 in the morning, 180 mid-day and 360 at night around bedtime(mostly to coincide closely with the times for my most frequent hits). ;)

Pfunk 8)

Title: Re: verpapamil
Post by tanner on Feb 28^th, 2006, 1:25pm

I am just now bumping my dosage from 480 a day to to 640 because the severity of my ha's has been increasing. I just started the increase 2 days ago and am experiencing dizziness and heart rhythm's are off. I have been on much higer doses than this in the past. Any thoughts as to what i am doing wrong. am i pushing the dose too quickly? I am also VERY spacey. I had this reaction a couple years ago but i was also on neurontin at the time and as soon as i dropped that crap the zombie feeling went away so i figured it was the lone culprit.

i would appreciate any advice..........tim