Finishing up a taper... this is the typical treatment for me to break my cycles... have had success in the past.

This one drastically helped the severity and frequency of my CH, however I am at the end of the taper, still getting shadows.

Does anyone have any insight about the efficacy of a Pred Taper...

My cycles are a couple years apart... in the past the pred brought me out of it all together after a week... this time, these shadows are making me nervous.

Prednisone can effectively break a CH cycle, but it should be a transitive therapy, not the sole weapon.  Sure, longer tapers can maybe outrun a 4-6 week cycle (I tried that once), but it becomes prednisone abuse.

You should find a headache specialist who can treat CH better than a GP.  My GP also dissed O2 as an 'incovenient' option, and my neuro preferred Rx over O2, but then I found a HA specialist who believed O2 the best abortive.  A good HA specialist should set you up with a preventive therapy like verapamil or lithium, with maybe a pred taper to block attacks while the prevetive builds up, and O2 or Imitrex injection to abort.

Pred alone with Imitrex pill is just not state of the art therapy, but seems typical from a GP.

Please find a HA specialist if you can.

Fox

well stated by Fox

thanks.  Thanks for the feedback. 

Prednisone had always been effective for me until just recently. I was CH free for 7 years and immediately asked for my prednisone taper at the onset of this cycle. If it decreased the severity, I cant even imagine the pain  I would have experienced without it. I was on it for a total of 4 weeks and have no idea why it didnt work this time. How long have you been on it? You may ask for another taper and see if that knocks it out.

The more frequently and the longer prednisone is used the less responsive to it our body becomes.

As Fox says, for CH it is a transitional treatment only that should be used to allow your preventative treatment of choice to build up to therapeutic level. A prednisone taper is therefore best started simultaneously with your preventative med.

Although there are cases (you seemingly being one of them in the past) in which pred has broken a cycle, generally the pain returns almost immediately after pred is being tapered off. Your latest experience therefore is the norm, rather than the exception.

Most people here would recommend a taper that commences at 60-80mg or so a day, then tapering off by 10mg daily or every second day to zero. You will find few people that advocate the use of prednisone over extended periods of time or for the duration of an entire cycle.

Of the 1134 respondents that took the Cluster Headache survey in 2008, 600 (52%) had tried prednisone.  Of these 600, 384 (56%) rated prednisone effective.