From "Headache" magazine:

Quote:

Keywords:cluster headache;lithium;preventive treatment;naturalistic study Objective.— In this study, we attempted to evaluate the response to lithium treatment and its tolerability in the prevention of episodic cluster headache (CH) and to identify clinical predictors of response. Background.— Verapamil and lithium are the most widely used drugs in the prevention of CH attacks. Lithium is considered a second-line treatment in part because of its potentially severe adverse drug reactions (ADRs). Evidence for the efficacy of lithium in CH prevention is greater in chronic than in episodic patients. In addition, because of its narrow therapeutic window and ADRs (which can be significantly reduced with proper periodical monitoring of blood levels), lithium is recommended only in chronic CH, when other drugs are ineffective or potentially harmful. Methods.— Our primary aim was to determine whether lithium reduced the number of attacks per day (attack frequency). We compared attack frequency in 3 periods: run-in, the first, and the second week of lithium treatment. Responders were defined as patients showing at least a 50% reduction in attack frequency. Results.— Lithium response was evaluated in 26 patients. Treatment led to a significant reduction in attack frequency within 2 weeks in a percentage of 77% of responders and 23% of nonresponders. Responders and nonresponders did not differ in terms of demographic and clinical characteristics. Only 15% of patients experienced mild ADRs. Conclusion.— Our study provides additional evidence on the effectiveness of lithium in the prevention of episodic CH. It also shows the tolerability of lithium, given the short duration of treatment and low dosage.

I've used lithium as my primary prevent for well over 25 years. 52 year old male episodic, I take 1200 mg a day while on cycle. Thus far my only side effects have been excessive urination for the first couple of weeks, and a light lethargy easily overcome by an extra cup of coffee.

Great post Bob, thanks.

Joe

thank you Mr.Bob...i too use it with verap...i had no idea that this is used for CH,as i use it primarily for my E.D.  :D :D :D :D :D

Thanks for this. My doc has been reluctant to prescribe lithium due to worry over the ADRs, so perhaps this will persuade him.

I was on lithium for about 2 years. It worked fine then my doc said my blood levels were too low and increased the dosage even though I didnt want to... after that I threw up every day for months and couldn't manage work cos of the constant nausea. She then wanted to take me off work cos of the SIDE EFFECTS uff... after that no matter what dosage changes made I couldn't take the med.

But before the dosage flipping about it was absolutely fine to take the stuff and CH wise was pretty well of those two years.

This was one of the things they tested whle they didn't really know "what was wrong with me".

I took lithium 900mg for two years.  It reduced the number of ch I had a day from 8 to 4.  Then one day it just quit working.  So I moved onto different drug.