Hey guys.

I am dealing with the longest cluster cycle I have ever had. Yesterday marked week 5 of at least two a day. My neurologist recently switched me off of Depakote and started lithium. We had tried Verapamil 180mg, but that made me super light-headed, and we backed it down to 120mg.

My last cycle was aborted via occipital nerve block. It has failed to work this time around.

I'm trying to stay positive.

I'm also ready to try anything and everything to break this cycle. I've already had to drop all of my classes for this semester because I haven't been able to goto my college classes. Abortive meds, such as Imitrex and Zomig make me feel like run over whale poop. Not to mention, I feel rather concussion-ey all day after a bout of cluster attacks. I just can't think straight and I have a tremendous time just trying to form sentences.

Other than meds (I am counting oxygen as a drug) and water, what are some of the tricks you have tried to stop the beast? Have you changed your diet? Does cutting out any particular food help with your headaches? I have an appointment with my neurologist again tomorrow, and I hope another occipital block will help. Oddly enough, it's usually the contra-side that helps. My H/A's are right side, the left side occipital block seems to work.

Thanks guys.

Print out the PDF file and use it to discuss options with the doc.
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Bit of a stretch but ask doc to consider a trial of this abortive which, for some, stops cycles. Personally, I found that 10mg both aborted a current attack and seemed to have some carry over preventive effect lasting a day or two. It works fast and clears your body fairly fast so that a trial is not risky.
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Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.


Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ]

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Why are you including O2 as a drug? lance

Thanks for the reply.

Wimsey,
I am counting oxygen as a drug because it technically is one. You need a prescription to use it. Also, in my 20+ years as a paramedic, every jurisdiction I've ever worked in considered it a drug.

It's a "drug" we all use 24x7 until the day we die. The only difference is that when we use it to kill of CHs we use it at 100% concentration.

You tried Batch's vitamin D3 course yet? Might be worth checking out if you haven't. Not sure what else to recommend as I really don't know what you've been taking. Your Verapamil dosage looked kind of low, but I'm not an experienced user of that drug. You could also try a pred taper to buy some time until the lithium kicks in. Good luck