Hi,

Came across a post by someone on another board claiming good results with verapamil and cyproheptadine.

Has anyone tried this combo? I have not heard of cyproheptadine, any comments?

Verapamil is of course a well known long term preventative for CHs. Cyproheptadine is an antihistamine with some history of use with migraines. Never heard of it being used for CHs but that doesn't mean anything. I'd be interested in knowing its use specifically for CHs or if it's just another migraine med migrating over cuz the docs don't know what else to offer. Blessings. lance

I did a search and found several posts about it, all used it as a secondary prevent in addition to more common prevents like lithium and verapamil. Certainly not a front line prevent but it seems to have helped several sufferers. Do keep us updated on how it works for you:

Interesting comment on the serotonin receptors:

Although cyproheptadine is an antihistamine, it also blocks the serotonin 5-HT2a receptors.  So it has some action like kudzu and olanzapine. 

And a reference to it in an older OUCH newsletter:

There's an article on histamine and cluster headache in the most recent OUCH newsletter - START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

From an older post 2008:

Cyproheptadine (periactin) is an anti-histamine and serotonin antagonist that is sometimes mildly helpful for clusters.  It is best used in conjunction with other meds for people with  hard to treat CH.  Fatigue and weight gain often are a problem for those who use it. 

Hope this is helpful.

Joe

wimsey1 wrote on Mar 20^th, 2012 at 7:45am:

....or if it's just another migraine med migrating over cuz the docs don't know what else to offer. Blessings. lance

That was my experience in 1985>...doc had no idea what ch was so treated like migraine (heck, what else was he gonna do, what little is known now was barely known then). We did the whole migraine thing...Inderal, Tenormin, Fiorinal, Amitriptyline, several others I've forgotten...and Periactin. None of them did nada...but he was willing to script O2...which I had to introduce him to as a ch treatment. BEST by FAR...even tho I wasn't using right.

What intrigues me and possibly the medical community at the time, when ch was sometimes referred to as "histamine headache", is that early in my ch career ('82-'85,pre 1985 diagnosis) antihistamines seemed to help a little. I was all over the Periactin because I figured YEAH...that's the one....a really strong anti histamine! Was SORELY disappointed.

Never tried in combination with anything else besides the O2...so ???....But, this is the first I've heard about it in 20 years...thinking we would have heard more if it was successful  for more than a few. My bet is on the verapamil.....



Best,

Jon

Search produced 8 abstracts ranging from 1976 to 1987; nothing since. Two of them reported some inconsistent improvement but that the med disappears after that tells us what we need to know.

I'm a chronic CH sufferer for 22 years and I have been on cyproheptadine along with verapamil and Elavil for probably a decade and have had good results.  Occassionally a cycle breaks through and we knock it down with a course of prednisone or two, but all in all it seems to help.

When, over the years we've tried removing any one of the three main preventative medications (by tapering), including the cyproheptadine, the headaches have returned.

Plakatboy wrote on Mar 20^th, 2012 at 1:36am:

Hi, Came across a post by someone on another board claiming good results with verapamil and cyproheptadine. Has anyone tried this combo? I have not heard of cyproheptadine, any comments?

Intersting. Cyproheptadine is used to treat serotonin syndrome, so I would think that, if anything, using  it might actually be more likely to induce a CH than prevent one.