Headache. 2015 Apr;55(4):571-4.
Clomiphene citrate as a preventive treatment for intractable chronic cluster headache: a second reported case with long-term follow-up.
Rozen TD1.
Author information Geisinger Health System, Department of Neurology, Geisinger Headache Clinic, Wilkes-Barre, PA, USA.
Abstract
OBJECTIVE: To describe a second case of treatment refractory chronic cluster headache responsive to clomiphene citrate and with long-term follow-up.
METHODS: Case report with 7-year evaluation.
CASE: A 63-year-old man with a 17-year history of chronic cluster headache preceded to have significant adverse events or was nonresponsive to multiple cluster headache preventive medications including verapamil, lithium, valproic acid, topiramate, baclofen as well as greater occipital nerve blocks and inpatient hospitalization. The patient experienced 3-5 headaches per day. On clomiphene citrate 100?mg/day he became 100% pain-free and remained so for 3.5 years with only mild fatigue as a side effect. He then had cluster headache recurrence and did well on gabapentin for another 3 years with repeat headache recurrence. Clomiphene was restarted, and he became pain-free once again.
DISCUSSION: This is the second reported case of the effective use of clomiphene citrate for the preventive treatment of medicinal refractory chronic cluster headache. This is the first case to report long-term follow-up of this neurohormonal treatment. Clomiphene citrate appears to be safe for extended use in chronic cluster headache even in an elderly sufferer and has a minimal side effect profile. The mechanism of action of how clomiphene prevents cluster headache may involve both its ability to enhance testosterone production and its ability to bind to hypothalamic estrogen receptors. Clomiphene citrate should join the list of alternative cluster headache prophylactic treatments to be considered by headache specialists when conventional cluster headache preventives are ineffective.
© 2015 American Headache Society.

PMID:25828543[PubMed]

I too had incredible success with the Clomiphene 50mg/day, 5 yrs pain free.  The headaches returned two weeks ago, I got my neuro to prescribe me Gabopentin.  No success yet still getting the night time alarm clock wake me straight up headaches.  I will keep you posted on my progress.

Steve

Hi plateglass
Gabapentin is epilepsy medicine, and will work for some who have trigeminal neuralgia, but won't touch clusters. I took it for over 2 years.

Ive taken Gabapentin for a few months. It caused me to black out and hit the floor on several occasions, waking in a pool of blood  :'(

Devils Keeper - not quite that bad for me, but I did have some serious dizzy spells and for the first few weeks and till my body got used to it I did nothing but sleep. Now, I've had serious insomnia my whole life, so to suddenly be sleeping 18 hours a day was extremely odd. And the hours I was awake - I may as well have not been. I also had one of the rare side effects which is difficult to explain, almost "out of body" if that makes sense. I was glad when I found out it was the wrong med, and I could stop taking it. Nasty stuff !!!

Thank you everyone, for the advise.  I will give it another week to see if it has any success, but I will be extremely careful with the side effects.  Just hoping for something that worked as well as the Clomiphne. 

Steve :)

I took it before I had been correctly diagnosed with CH.
I THOUGHT it was working because the pain went away, but really it was just the cycle ending. I didn't know about cycles then.