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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Verapamil questions
        
(Message started by: cherylc on Feb 17^th, 2005, 8:39am)

Title: Verapamil questions
Post by cherylc on Feb 17^th, 2005, 8:39am

Looking for some information about the use of Verapamil. Had to come to the people that know!!

1. Is it used as a preventative, abortive or both?

2. What dosage do you find most effective?

3. For chronic sufferers...does it reduce the number of h/a's per day?

4. Do you use other medicatons with it? Can you still use triptans while taking verapamil?

5. As a episodic sufferer, I am considering taking this year round as a preventative. Any noticable side effects?

Thanks in advance for sharing your knowledge!!! :)
Cheryl

Title: Re: Verapamil questions
Post by nani on Feb 17^th, 2005, 8:45am

Hi Cheryl:
1. I use it as a prevent (haven't heard of it used as an abortive)
2. I take 360 mgs a day (less does not seem effective for anyone - some folks take more)
3. I found it helpful in that it lessened the severity of hits, not necc. the number.
4. I also use lithium and Neurontin as prevents (and now I'm using kudzu, B complex and minerals) These additions have really given me significant relief
5. You must discuss side effects with your dr. If your BP is low, it may be dangerous

Good luck to you. PF wishes, nani

Title: Re: Verapamil questions
Post by Bob_Johnson on Feb 17^th, 2005, 1:16pm

: 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).
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Verap may reduce frequency and intensity--only experience will reveal your body's response.

Yes, you use other meds to abort an attack.

Using it year around or not is an unresolved question. I know of one leading doc who does push using 100%, others claim that the effectiveness is reduced thereby.

Title: Re: Verapamil questions
Post by debmcd on Feb 19^th, 2005, 4:38pm

My hubby is on 480mg Verapamil a day, along with 100 mg topamax and 400mg B-2. Verapamil seems to be working well and we're going to see if he can taper off the topamax (yucky side effects).

Title: Re: Verapamil questions
Post by don on Feb 20^th, 2005, 1:16pm

480 mg per day is effective for me, only when in cycle.

Takie it year round and you run the risk of it being less effective when you need it the most.

Title: Re: Verapamil questions
Post by Mr. Happy on Feb 20^th, 2005, 6:29pm

Taking anything, all the time, when absolutely not needed, shouldn't be anybody's first choice. On the other hand, there's a school of thought that sez drop that daily high dose down to a minimum.......like 40 - 80 mg/day......it makes ramping up the dose effective faster. Then there's the other school that sez Verap extends cycles, period.

It's definitely hard to choose,
RJ
http://mushys.com/pix/necklace4a.gif

Title: Re: Verapamil questions
Post by Cooked Brain on Feb 25^th, 2005, 10:24pm

Hi Cheryl,

The dosage it starts working for me is 2x120mg SR a day. Before I come to that point I take 1x120mg a day for about a week, and the play the double. Usually then my cycle is broken within the 2nd week.

Broken cycle means for me: no more nighttime headaches, no morning headaches, only minor shadows during the day, until real end of cycle. That's when I start to taper off for about 2 weeks back to 0 :)

There is no hazard mixing verapamil with triptans that I heard of. Still respect the daily maximum for the triptan that you are using, and don't use different triptans on 1 day. Instead for painkilling I would strongly recommend o2.

Pfd & take care!

Title: Re: Verapamil questions
Post by sandie99 on Feb 26^th, 2005, 1:42am

Verapamil made my chs milder once I started taking it. I take it as preventative, 400mg/day. The only side effects I've had so far was regular HA on my first week and that's it. Good luck! I hope it helps with your ch! :)

Sandie

Title: Re: Verapamil questions
Post by histic on Feb 27^th, 2005, 9:12pm

Finally, after ramping up to 540mg/day plus 3 Indicin (morn, noon,nite), the headaches dropped from 3/day to 1/day to 0. Took about 3 weeks. Side effect: CONSTIPATION! So, had to take 3 Senokots/day to counteract that. Verap is a preventative. Also, Dr. says you must watch your blood pressure while on Verap. Can also cause lower leg swelling (adema). I also used oxygen, which was very helpful (4-6 liter flow).