Carolyn wrote on Jul 2^nd, 2010 at 5:09pm:


How were you using the O2, what type of mask do you have, what was the lpm?  Did you get to the O2 as soon as your headache started or did you wait?  All these are factors in how successful O2 is (unless you are one of the few that O2 does not work for).

There are many other prevents beside Cymbalta (duloxetine).  It is rare that opiods work for clusters and even if they do, there is a high possibility of rebound headaches.  Not to mention the fact that you're dealing with a highly addictive drug.

deltadarlin'~aka~carolyn (supporter)

For many CH sufferer's Narcotics often make a CH hit worse not better, needless to say the worse pain starts before the narcotics may or may not knock you out. 

Read all you can on this site and for your sake don't use narcotics to treat a CH hit as I said they can make the pain worse and cause nasty rebound CH hits.

Check with your doc and get on a daily prevent if you're not already and get O2 and imitrex to stop the hits when you get them.  Ask your Doc about Verapamil or Lithium as daily prevents.

You have a fine support group which you may wish to explore:

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
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Medical literature and our collective experience shows that many neurologists have very limited education in treating headache. If your doc is open/receptive, you may wish to print out this material and give to him. At the very least, it will give you some tools to use discusss treatment options. As noted, using narcotics for CH signals a doc who is not.....

See the PDF file below.
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Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]