Prednisone can effectively break a CH cycle, but it should be a transitive therapy, not the sole weapon.  Sure, longer tapers can maybe outrun a 4-6 week cycle (I tried that once), but it becomes prednisone abuse.

You should find a headache specialist who can treat CH better than a GP.  My GP also dissed O2 as an 'incovenient' option, and my neuro preferred Rx over O2, but then I found a HA specialist who believed O2 the best abortive.  A good HA specialist should set you up with a preventive therapy like verapamil or lithium, with maybe a pred taper to block attacks while the prevetive builds up, and O2 or Imitrex injection to abort.

Pred alone with Imitrex pill is just not state of the art therapy, but seems typical from a GP.

Please find a HA specialist if you can.

Fox

thanks.  Thanks for the feedback. 

The more frequently and the longer prednisone is used the less responsive to it our body becomes.

As Fox says, for CH it is a transitional treatment only that should be used to allow your preventative treatment of choice to build up to therapeutic level. A prednisone taper is therefore best started simultaneously with your preventative med.

Although there are cases (you seemingly being one of them in the past) in which pred has broken a cycle, generally the pain returns almost immediately after pred is being tapered off. Your latest experience therefore is the norm, rather than the exception.

Most people here would recommend a taper that commences at 60-80mg or so a day, then tapering off by 10mg daily or every second day to zero. You will find few people that advocate the use of prednisone over extended periods of time or for the duration of an entire cycle.