New one on me, especially since your dose is so low. But calling the doc is the correct move. IF it turns out NOT to be the Verap, suggest you print the following and share with your doc. This approach has become well accepted.
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Headache. 2004 Nov;44(10):1013-8.   

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.

    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).

I've heard of low BP, constipation, a feeling of depression, fatigue, irritability, diziness, ED, etc., but never this.  Don't eat grapefruit while on verapmil, and be sure no other meds are interacting with it.  Every person can have unique side effects to any med, so good call on talking to the doctor.  Let us know if the symptoms continue even after you've stopped the verapamil.

Well that's good news.....like Bob said, don't be suprised if they ratchet that verapamil dose up a bit. Many go ito the 960 mg a day range to get relief.

Joe

I tok 620 mg daily last cycle.  I had shaky hands and would get charley horses in my feet.   Never got the constipation ,  did get the fatigue though. 

Good move in calling your doc just to make sure things were okay.

Good luck to you

kelly

Hated the stuff.  Nothing but bad things happened when I was on it.  Also had the same experience with low blood pressure.  My feet swelled up pretty big ... I made a great Hobbit!

if yrpriscriped vapramil how long u supposed to take it 4? i was priscribed this took it for amth then stoppe as r never treat sum 1 for ch and wasnt sure how long u shud take it 4?? she sujested i took untill my cluster was over it alsted about 5 weeks?? with the 1st week the worst!!

I'm into my 5th month with Verapamil at 480mg daily and when this cycle started, I went on it full dose. Not good, trip to the ER for too low blood pressure. I backed off on the amount and gradually upped it until I reached the 480mg level. Much better.

I am tapering off very slowly to see where I am at with this cycle, so far so good as I am down to 240 mg daily, and no hits as of yet!

I am coming off early this time as my cycles usually last about one full year, but I have a "gut feeling" this time.

Everybody is different when it comes to how and what meds work for each individual person, so always work with your doc on this.

My friend Jonny once told me never to increase or decrease my meds without my doc's approval.

  Barry

I was trying to find some info on how verapamil works in CH. I understood that the drug had the action of being a vasodilator (I used to work in cardiology so had experience of it being given to arrhythmia patients - of which I ended up being one too!), so was curious as to its mechanism in CH, given that triptan vasoconstrict...



I just went up to 360mg yesterday, so far havent had an improvement, maybe too early, maybe not high enough dose yet?

A couple of entries ago on this thread, Marie asked what a cycle is...

The more common form of cluster headache is 'episodic,' as opposed to the less common 'chronic' form.  

The term episodic means that we have episodes of cluster attacks, followed by pain-free periods of remission.  Chronic suffers are not so fortunate.    

Those of us who are episodic often refer to an active episode of headaches as a 'cycle.'

Dennis

saw my gp today and theyve put me back on the vapmaril but long term untill i can see a nuro at the very least there also trying with the nasal spray xx they said i can try the o2 erepy too so will see what happens xx