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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Verapamil dosage and CH
        
(Message started by: Lotus on Sep 2^nd, 2007, 8:09am)

Title: Verapamil dosage and CH
Post by Lotus on Sep 2^nd, 2007, 8:09am

We have discussed many times on the Board about what dosage of Verapamil would be considered effective for prevention of CH attacks. Although this varies from person to person but the common theme is that one tends to need a much higher dose than normal ( normal as to when using it for hypertension ) for it to work. Many of us here talk about dosage of 640 mg and 720 mg per day, with some going as high as 960. The normal dosage used for hypertension is usually between 120 mg and 240 mg per day.

It is very interesting to me that while in cycle Daniel needed to use and could tolerate up to 720 mg per day of Verapamil. At that dose, he was fine, no side effects and his daily BP was around 110/70. Now he has been out of cycle for nearly 3 months but he still stays on Verapamil because he has existing borderline hypertension. His specialist maintained that he should stay on it. However, out of cycle he could only tolerate 180 mg of Verapamil per day, any higher than that and he would get bad side effects like fluid retention, bad constipation and light headedness.

I found this to be fascinating. Its like CH changes the whole bodys metabolism when it comes to medication while in cycle.

Does anyone else experience this? Just curious.

Annette

Title: Re: Verapamil dosage and CH
Post by Brewcrew on Sep 2^nd, 2007, 9:23am

Don't know, Annette. I've been off it for over a year, and when I was on it, I didn't take it when out of cycle. In cycle I was on 480mg/day, and that seemed to be the magic number (combined with 900mg/day lithium).

Sorry I couldn't be of more help. Interesting thought process.

Title: Re: Verapamil dosage and CH
Post by Lotus on Sep 3^rd, 2007, 2:32am

Thanks Bill.

Its interesting as in no other cases than CH that a person can tolerate/need a dosage so high.

If anyone else here uses Verapamil for blood pressure out of cycle please share your experience. Thanks.

Title: Re: Verapamil dosage and CH
Post by Jonny on Sep 3^rd, 2007, 3:45am

I went to see the doc that diagnosed me because the HAs were coming back after my PF 14 months......he asked me "Whats up with the high blood pressure"

I told him that this was maybe the second time in 15 years of seeing him that I was not taking Verap (because I ran out)......"You will need to take it even if the HAs go away for good" is what he said.

So, im taking the Verap even though I hardly ever get hit.

HAs are one thing....getting old just plain sucks......LOL ;;D

Edit to add: Im taking 480 a day and he sees no problem with that......I think, or he would have said so, right?....LOL....I dunno :D

Title: Re: Verapamil dosage and CH
Post by Lotus on Sep 3^rd, 2007, 4:08am

Thanks Jonny

So you have hypertension outside of CH too? Do you take the same dose of Verapamil now as when you were getting more headaches?

I guess if its working and you dont have side effects then there is no need to change the dose.

Maybe the reason you can take higher dosage of Verapamil even when you hardly get hit now because you were considered chronic for many years ( apart from that nice 14 months break you had ). I wonder if being chronic is like having one long non stop cycle, even if the frequency of the attacks varies, and therefore the body's metabolism is still altered ?

If being in cycle means that one's whole body, including the metabolism, is affected, then it points to more central causes of the condition. This ties in with Prof Goadsby's hypothalamus theory and it makes other causes less likely.

Now we need to find out what would cause the hypothalamus to suddenly swing out of whack in the first place ::)

Stress? Drugs? Genetic activation? Head injuries? Sleeping disorders?

Just thinking outloud here folks :)

Any other thoughts or experiences ?

Title: Re: Verapamil dosage and CH
Post by DennisM1045 on Sep 3^rd, 2007, 9:27am

Hi Lotus,

I have hypertension. Not bad but its there. When I suggested to my PCP that I thought I had CH she put me on verapamil. 240mg at the time. Then my cycle ended and I found I couldn't tolerate that dose. I kept passing out anytime I tried to exercise.

So now I'm on 180mg verap + 12.5mg Hydrochlorothiazide. When not in cycle this seems to be a good combination for my hypertension. bp=110/80.

I just started another cycle and I notice that my bp is up significantly, 145/95 this morning. I'm going to call my neuro and ask to up my verap again.

In short, I think you are on to something here.

-Dennis-

[edited to correct bp #s]

Title: Re: Verapamil dosage and CH
Post by nani on Sep 3^rd, 2007, 12:04pm

on 09/03/07 at 04:08:34, Lotus wrote:

I wonder if being chronic is like having one long non stop cycle, even if the frequency of the attacks varies, and therefore the body's metabolism is still altered ?

Um, that's exactly what chronic is.

I was on 480 mgs of verap while chronic. Went to 240 mgs for my blood pressure for another year or so. My doc just changed me to a beta blocker, since it's better for my heart. I really can't say that I tolerated it any differently while not in cycle.

Title: Re: Verapamil dosage and CH
Post by Kilowatt3 on Sep 3^rd, 2007, 1:31pm

on 09/02/07 at 08:09:43, Lotus wrote:

It is very interesting to me that while in cycle Daniel needed to use and could tolerate up to 720 mg per day of Verapamil. At that dose, he was fine, no side effects and his daily BP was around 110/70. Now he has been out of cycle for nearly 3 months but he still stays on Verapamil because he has existing borderline hypertension. His specialist maintained that he should stay on it. However, out of cycle he could only tolerate 180 mg of Verapamil per day, any higher than that and he would get bad side effects like fluid retention, bad constipation and light headedness.

I found this to be fascinating. Its like CH changes the whole bodys metabolism when it comes to medication while in cycle.

Does anyone else experience this? Just curious.

Annette

Hi All,

I have no experience with Verapamil, but I have noticed something similar with caffeine!

Usually, I am very sensitive to caffeine - a couple of soft drinks in the afternoon, or a cup of coffee after dinner, and I'll be awake half the night. But while I'm in a cluster period, the caffeine has much less effect. Chasing shadows on Saturday, I had a 16 oz. Rock Star and three or maybe four 8 oz. Red Bulls, all fairly late in the day, including one at around midnight. A half hour later I was sound asleep for the night. The clusters must do something to our metabolism, as that amount of caffeine would ordinarily keep me up all night!

Just my $.02 worth!

Regards,
Jim