Duck_Soup,

With the exception of an occasional snort of imitrex nasal spray during airline travel, all I've used over the last 5 years is oxygen therapy at flow rates that support hyperventilation...  It's been 100% effective with very short abort times.    I use no other prescribed preventatives or abortives.

Sure, I still have CH attacks, but since I started using this method of oxygen therapy, the hits are very manageable, slow to build, and the abort times very short...  two to three minutes on average using oxygen flow rates that support hyperventilation...  some as little as a minute.

A typical low cycle frequency for me is 3 to 4 hits a week and most of them are at night while sleeping and some are so mild they're gone by the time I get to the oxygen.

I do go into high cycles from time to time during the year and these high cycles always coincide with a low arterial pH (I measure my saliva pH as an analog of arterial pH). 

I keep a log of my saliva pH with the average of three measurements taken the same time each day and have found a clear relationship between low saliva pH with an increase in the frequency and intensity of my hits.

I turns out a low arterial pH at the low end of, or below the 7.35-7.45 normal range (too much acid) acts as a vasodilator for me and that appears to make the CH triggering mechanism more effective with an increase in the frequency and intensity of my hits.  A low pH also makes the aborts with oxygen therapy take longer than normal. 

A slightly higher arterial pH (more alkaline) at or above 7.45 tends to act as a vasoconstrictor and that impedes the CH triggering mechanism with a decrease in the frequency and intensity of my hits.  An elevated pH also shortens the abort times with oxygen therapy for me.

When I realize I'm going into a high cycle of 3 to 4 hits a day, I start taking 4 to 6 calcium citrate tablets with vitamin D, magnesium and zinc washed down with a big glass of homemade lemonade each day.

This regimen acts as a buffer on gastric juices and that will start to elevate my arterial pH in 3 to 4 hours as measured with saliva pH.  I also shift my diet when I go into a high cycle away from acid forming foods to eating more alkaline forming and anti-inflammatory food types...  This regimen works well for me and others who have tried it.  The following links may help:

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Hope this helps explain some of your CH problems,

Take care,

V/R, Batch