My last cluster headache was about two years ago and was brroke very easily with a high dose of decadron.  Although it did break the attack i suffered an extreme mental change within 24 hours of taking it.  Now two years later I am having another episode.  The doctor gave me prednisone 20 mg once daily.  It is helping some with the throbing pain but still have alot of discomfort behind my eye.  So what my question is...Should the dose of prednisone be higher to break the pain or is 20 mg enough?

There is no standard dose. Medical literature notes from 10 to 100mg starting.

If you had emotional changes the first time, ask the doc to start again at a dose just smaller than the first cycle, in hopes that will avoid recurrence. (Only a guess on my part that this might work.)

I have never taken more than 10mg daily in the last few years. (Doc does not really like this stuff) Worked for me.

It depends.

If you weigh around 70 lbs., it probably is.

As far as I know recommended dosage is 1 mg/kg bodyweight.
I was on 96 mg/day for weeks and worked perfectly but gave up 'cos of side effects.

Thanks for your input... Does the first dose normally kick it out of you or will it take a few days?

I weigh 125lbs, 5'4" and I was put on 50mg for 3 days, 40mgs for 3 and so on until I was off the prednisone.  It stopped the attack (I am epsiodic) until I got to around 30mg.  Usually I respond very well to the cortisteroid but we had to up the Verapamil.  My neuro uses the prednisone to stop the attacks and to increase the prohylactic (Verapamil in my case).  I also use O2 (works great) when home, Imitrix at night, Rock Star Light Energy drinks which really help, too.

There is no "right" amount of the prednisone, as has been posted.  I know that the dose I was on, starting with 50mg, was also one I was one for a poison ivy attack several years ago.  

The main side effect I get from the steroid is speediness!  I get a lot done, anyway!

As always, ask you doctor about the med and the dosing; why 20mg?  How long to take it?  What other options are there?  You are your best advocate! :)

I was prescribed Predesilone at 60mg for a week and then reducing
by 10mg every 4 days until course was finished. During this period i did not suffer even as much as  a shadow but when I finished the course the beast returned with a vengeance. I have recently been given the advice to begin a preventive course such as lithium or Verapamil when on the Predesilone because they take a couple of weeks to start working on the system. 20mg of Predesilone sounds a very small dose to begin with but hey I'm no doctor.

Lefty..!

lefty is right i always started on about 60 to 80 for a couple days then gradually tapered down 20 mill. at a time over about a week's time until off. always knocked it for me until the verapamil and lithium combo kicked in.

Prednisone is funny...for some, it will actually halt the cycle with a quick 10 day burst! For others...like me...it only blocks them. As soon as I go off the prednisone, the CH comes right back. Now, like several others just posted, I use it for the 10-14 days it takes my lithium to kick it into gear.

Joe

im ready for something new besides the o2 and imitrex,, ive done that prdnisone taper last cycle i dont think it work very well,, whats this litium deal? i can score some down here in mex im sure whats the dosage?

Finn,

Talk to your doctor!  Have you tried Verapamil?  These are meds that really require your doctor's input!

My neurologist talked about Lithium if the 480mg verapamil was not working for me...  

Collaborate with your doctor....

And the combination of lithium and verapamil seems to be the silver bullet for some. When I did the combination, I was taking 480mg of verapamil and 900mg of lithium. Worked like a charm.

But do work closely with your doctor on the lithium. I always thought the doseage was based on body size but was corrected by a doctor. It all depends on how YOUR body metabolizes it. So a safe dose for a little guy, could cause lithium toxicity in a big guy.

I use lithium at 1200 mg a day while on cycle. The first time I went on it I had to endure 2 weeks of almost every other day blood draws while we established what was a therapeudic level for me.

It's been the silver bullet for me, blocks about 70-80% of my attacks.

Joe