Hi all,
I have been reading alot of posts about those on topomax, verapamil, etc and still using abortives like oxygen, imitrix, and even red bull.  This has been the wackiest and strongest cycle I think i have ever had and definately never the time of year i have gotten them.   (Maybe the polar vortex).   I am episodic and the first time i have sought treatment from a neuro.  To make a long story short i started topomax.  25 mg at night and half a pill in the morning.  In combination with 600 mg ibuprofin the headaches went away in 48 hours.   I am only on 25 mg of topmax at night and feel shadows during the day on and off.   I have greatfully not needed pain meds in over a week.    The question I have is do most people need abortives with the other meds?   Is 25 mg even doing anything?  Have another appt with neuro next week but wish i had come back and read more before last neuro appt.   You guys and gals are the best.    Thanks for taking the time to share.   

Craig

Looks like you would benefit from working with a headache specialist.
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LOCATING HEADACHE SPECIALIST

1. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

2.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

3. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE; On-line screen to find a physician.

4. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

5. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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WHY A HEADACHE SPECIALIST IS RECOMMENDED


Headache. 2012 Jan;52(1):99-113.
Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden.
Rozen TD, Fishman RS.

THERE REMAINS A SIGNIFICANT DIAGNOSTIC DELAY FOR CLUSTER HEADACHE PATIENTS ON AVERAGE 5+ YEARS WITH ONLY 21% RECEIVING A CORRECT DIAGNOSIS AT TIME OF INITIAL PRESENTATION.
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Pain meds are useless for Cluster but an abortive for attacks is essential. See the PDF file, below.

Top., used to reduce/prevent attacks, has been rejected by a number of folks here becasue of th menal confusion which it often creates. Verapamil has the best track record as a preventive (PDF file).

The standard protocol for Cluster then, is:

1. 10-day course of Prednisone to break the cycle rapidly,
2. At the same time, starting a preventive, such as Verapamil, which blocks/reduces future attacks. (Takes several days for it to become effective, so the use of #1 to give immediate relief.)
3. Using a rapid acting abortive to kill attacks which sneak thru. (again, PDF file.)

Sounds like a low dosage and ibuprofen is not found by most here to have any (positive) effect on CH. Sure you are dealing with CH?

It is imperative to work with a headache specialist, so let's suppose you are. I can think of several reasons why the interventions you describe are working. First, you may be cyclic and have come to the end of your cycle. For years I thought Sudafed was the ticket but that's only because in the beginning the cycles were so short. The second reason I can think of is you are subject to a cluster like headache, one that succumbs fairly easily. If so, rejoice! And we rejoice with you! Being pain free is the goal. blessings. lance