HEY ALL
HAS ANYONE TAKEN A PREDNISONE TAPER TOWARDS THE END OF THEIR CYCLE TO BREAK THE CYCLE? MY NEW DOC SEEMS TO THINK THAT WE COULD DO IT AS AN OPTION? JUST WANTED SOME FEED BACK
THANKS IN ADVANCE!!!
ANTHONY

Your doc's reasoning seems reasonable but you don't mention whether you are also on a preventive, such as Verapamil. I consider that essential.
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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).

A small percentage of people here have reported that prednisone has "broken" a cycle, but I remain skeptical. Prednisone will stop attacks dead in their tracks for many, but there's no way to prove or disprove whether or not the cycle was coming to an end naturally anyhow.

I'm one of the unfortunate majority! Pred will give me 100% relief, but as soon as I get below 20 mg a day, the beast is back. In the early 80's I did a bunch of "pred bursts" trying to break cycles but it never worked.

Some have posted that a pred burst or even a high dose taper has halted or broken a cycle for them. Hoping it kicks him to the curb for you!

Joe

taper starting off at 100mg helps me, sometimes it takes a second go round though. but those pf days are glorious!

Sometimes it's enough to just get several full nights of sleep under your belt to go do battle again.

Joe

I managed to break my last cycle with a pred taper.

Notwithstanding, it was the first time and came unexpected. Generally, I would think that chances are very low for a pred taper to break cycles, though it is clearly possible.