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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Verapamil: regular or sustained release, and other
        
(Message started by: zimmy on Feb 8^th, 2003, 8:43am)

Title: Verapamil: regular or sustained release, and other
Post by zimmy on Feb 8^th, 2003, 8:43am

Dear friends,

I live in Kenya and let me tell you, you have no idea how helpful this site is when you are in a situation where nobody has a clue about CH. And meds, well, the last month has been an adventure trying to get what I need.

I am confused by the efficacy of the regular release or sustained release verapamil. I have read some people advocating one over the other and vice versa. Which is best as a preventative? Also I can't seem to get the dosing right. I was on 720 mg a day and that worked for 4 days and when I stepped down to 540 the headaches came back. Do you have to stay at a high level for a while and if so how long before stepping down. My last 30 days have been a very up and down experience (3 days headaches, 4 days none, etc) and I think it is linked to my inability to get the verapamil dosage right.

I am still trying to get some O2 but have no more imitrex and can't get it sent here via the web-based pharmacies. Any suggestions when you have a crusher in the middle of the night and no meds at all or O2 as that is what I am looking at for the next 2 days, hopefully O2 tank is found on Monday.

Gratefully from Kenya,

Mark

Title: Re: Verapamil: regular or sustained release, and o
Post by Bob_Johnson on Feb 8^th, 2003, 10:01am

1. Best to stay on your Verap dose for the duration of your cluster cycle. Your past experience is the guide on how long to use it, that is, the length of your cycle.
2. Do not switch from regular to sustained forms. There have been cases of toxic reactions. Use one form of the other consistently.
3. If you cannot get imitrex, might try this med. I've had good results with it.

1: Headache 2001 Sep;41(8):813-6

Olanzapine as an Abortive Agent for Cluster Headache.

Rozen TD.

Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. The initial olanzapine dose was 5 mg, and the dose was increased to 10 mg if there was no pain relief. The dosage was decreased to 2.5 mg if the 5-mg dose was effective but caused adverse effects. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and two patients became headache-free after taking the drug. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. It alleviates pain quickly and has a consistent response across multiple treated attacks. It appears to work in both episodic and chronic cluster headache.

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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.