Drugs that worked don't seem to work any more.  Verapamil has worked well but every other year my doc has had to increase it to keep clusters "at bay."  I'm up to 960 mg now (but my doc won't increase anymore). Now, I'm taking 300 mg of Zonegran, too, which doesn't seem to be doing much.  Also taking 2 mg of Ergotamine Tart at bedtime.  I took a Prednisone taper hoping to "break" the cycle (it used to work years and still works near the end of a cycle).  It's been a month, but I'm considering another prednisone taper. and I hate prednisone!!

My questions are:  does anyone use Prednisone to break a cycle or just let the cycle run it's course?  Is there anything to help break the cycle?  Can someone expalin the process of tapering off of Zonegran, and down to 480 of Verapamil (after my cycle breaks).  Any help would be appreciated.  Thanks for your help.

I use prednisone to hold the beast at bay while my prevent kicks in. I use lithium, it takes 10-14 days to become effective. Prednisone gives me a break while the lithium builds up. There is a small percentage of CH'ers who can break a cycle using pred, they're are definitely in the minority.
I did a search on the other med, apparently it's in the same class as topomax which I haven't used. Can't give you any help there.

2 suggestions, talk to your doc about combining Lithium with your verapamil, we call it the chronic cocktail. It works for some as a prevent when either one loses it's effectiveness. Then check out this website:

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The only thing I've seen yet that completely breaks a cycle. I have not gone this route yet but several close friends on the board have and the success rate is pretty impressive.

Joe

Thanks for your reply.  I've read, some, of the Clusterbusters page but am leary of the  legal side of things.  Am not in a position of "getting caught."  I guess am just worried!!

Right now, on Verapamil, Zonegran, and Ergotamine, I feel really tired.  Does Lithium make you tired, too?  Does anyone out there have experience with Zonegran?  Is it prescribed not only for the pain, but for the duration of cycle????  Is it suppose to shorten the cycle?

I take Verapamil 80mg (Vasomil in South Africa) and Ecotrin and I must say I feel tired, confused, dizzy and nauseas all the time. I am not really sure if its working as I still get headaches and migraines, albeit that they are milder.

Craig

My cluster periods usually last 2 months no matter what I do. Should I get on the verapamil/prednisone any way? I did the prednisone this time hoping to break it and it didn't work. Never has for me. I hate the prednisone side effects. The prednisone seems to help for the first week to ten days, but as soon as I start the taper they are back.

If your CHs episodes are fairly predictable as to when they start it might well be worth starting on verapamil a couple of weeks before they are due to start. This will enable you to have built up to an effective dose by the time the episode is due to start. After all, avoiding a CH in the first place via a preventive is better than being able to abort one that has already started.

But do discuss this with your doctor first!

Also consider using the vitamin D3 and associated supplements that so many of us are using with success.

I agree with Mike. Some are able to predict their cycles so well they can start a round of verapamil beforehand, have it at serum levels during, and taper off after the cycle is gone. It would seem a good thing, why suffer more than you need? As to the prednisone effectiveness, many of us have found exactly what you describe: it works only at high levels which cannot be safely sustained over a long period. It can be effective though if taken as an intermediate while building up the verapamil in your system. Blessings. lance

That's a good idea. I went 5 years without a cluster,but I do get regular migranes for a week or so before the clusters hit. Other than the migranes, I was caught off guard. I will do that next time. Hopefully I am peaking now and for the next 4 weeks they will start the down hill side. Everything I try always just works for a short time. Even the oxygen takes longer and longer each time.