I receive my CH care from the VA.  I was episodic from 1981 until 2005-chronic since then.  Getting O2 from the VA was a nightmare.  Since it only works sometimes...and the CH inevitably returns within 20 minutes of stopping the O2, I asked to try Olazapine as an abortive.
 Since olazapine is a pysch drug my GP couldn't prescribe it...I had to go through Mental Health.  After a year (yes a friggin' year) of meeting with the shrink I convinced her that I don't care if they have to diagnose me as pyschotic to prescribe Zyprexa-I just want to see if it will work.  
Here are the results.

O2 alone-CH returns after stopping use.
Olazapine then O2- seems to work about 30% of the time.  Better than nothing.

The down side is the side effects and the limits on how often I can use it.  Is it worth it?  I'm keeping it on hand but feel that I wasted a lot of time and energy for this.

PFDAN y'all and a happy New Year!
kathy

Have you tried a highe dose of Zyprexa? (see abstract.)

Imitrex injection is generally 90% effective. Have you tried?
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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.

Kathy,

When I read this post last night, I too was wondering about the dose you used. Based on Bob's comment above, have you tried a higher dose?

I know about your struggles with CH and was hoping Olanzapine would work well for you.

Marc

I sure hope it works for you. Jeez I think you need a break.
Prayers are in.
the bb

wrote on Jan 4^th, 2009 at 3:02pm:

I sure hope it works for you. Jeez I think you need a break. Prayers are in. the bb

From here too.

Laurie

VA prescribed 5mg-up to 10 mg if that wasn't effective-at 5 mg there was no noticable effect-at 10mg there seemed to be a bit.  Imitrex and other triptans are counterindicated for me due to cardiac issues.
Thanks for the prayers.

PFDAN y'all
kathy

modified to add: Bob, I printed that abstract several times to show to the folks.  Thank you so much for posting it again-this has definitely worked for others so I hope I didn't discourage anyone from trying it.

  I used Zyprexa 5-10 Mg for a couple of years. It worked very well. I finally gave it up because of some rare unwanted side effects.
[smiley=smokin.gif]

I tried it again Friday night when I was a rockin at K8 half the night and got no effect from it for the second time at 5mg. I finally gave in to the DHE when I had enough of a break to draw it up and hit my leg. I still have 15-5mg pills that I am saving for STL, and next time I will try 10mg dose to see if any effect. It worked well for 4 days, but went wheels up after that so I took a break from it.

It was prescribed by my general / surgical Nero but the HA specialist would not do it for me.

Roland. :-/

Oh boy....I'm gonna try not to piss anybody off.  First off, I've tried it--didn't work for me, gave me real bad restless legs (guess it was really more like "restless body") and gave me a ridiculous zombie state that I could not shake for a day and a half.  I think it was truly the worst feeling I have ever had from any drug, period (and I've tried a few)  But all that is irrelevant....

What I really want to make sure people know is that this drug can produce some pretty nasty side effects ranging from low blood pressure, increasing the likelihood of having a seizure, rash, body aches and pains, elevated liver enzymes, vision abnormalities, chest pain,  rapid heartbeats, neuroleptic malignant syndrome, and Tardive Dyskenisia.   A bunch of this stuff can happen from other drugs that we take, like triptans, but it seems like common knowledge that people talk about on here, whereas I've not really heard anyone talking about the serious side effects this drug can produce.  Admittedly, a big problem with looking at these side effects is that studies on this drug are looking at people who take it every day, instead of just in response to a cluster--This makes me think most of the side effects listed, we probably don't have to worry about as much. (hopefully)  One of the things that really threw me off though, was my Doc telling me that even one dose of zyprexa can cause Tardiv Dyskenisia, a condition where you have weird involuntary movements, especially facial ticks.  Sometimes the condition goes away once you stop the meds, sometimes it never does.  You probably won't get it, it's a rare reaction.  But a rare reaction means it happens, and people should be aware of the risk.

If it worked, and I didn't have any other options I might take it....but I wouldn't make this decision lightly.