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This will help.

              Potter

Welcome to the board Lt. I've been dueling with the beast for 32 years and have found the best results from a 2 pronged approach. Many use variations of this to deal with their CH.

1: A good prevent. A med you take daily, while on cycle, to reduce the number and intensity of your attacks. I use Lithium at 1200 mg a day, blocks 60-70% of my attacks. Verapamil is a common first line prevent, but at doses higher then most docs are used to, some go as high as 960 mg a day. Topomax also has a loyal following, often referred to as "dopeymax" due to its potential side effect of making you loopy.

2: a good abortive routine. An attack starts, now what. As Potter mentioned, 02 should be your first line abort. Read the 02 link on the left as it must be used correctly or it won't work. I can abort an attack using 02 in 6-8 minutes. Beats the 90 minute rides I used to take.

Imitrex injectables are expensive but stop an attack even faster then 02 for me. I only use them when I get caught away from 02. Imitrex nasal sprays are cheaper then injectors and work for many. Pills don't work for most as they take too long to get into your system.

Energy drinks, chugged at the onset will abort or reduce attacks for many, look for those containing caffiene and taurine, the combo of those 2 is the trick.

Prednisone is a tricky one. For a small percentage, a short burst of pred will actually abort a cycle. For the rest of us, it's a temporary block, as soon as we stop the pred, the CH is back with a vengeance. For us, we use it as a transitional med, a 2 week taper of pred while we wait for our prevent to kick in.

Then check out   clusterbusters.com    alternative therapies.

Joe   

The early stages of CH are confusing, frustrating, scary--but learning is your best defense, second only to having a good HEADACHE specialist in your camp.

Explore the buttons, left, starting with the OUCH site and its many internal links.

Then the PDF file, below.

Then,



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]
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Consider,
MANAGEMENT OF HEADACHE AND HEADACHE MEDICATIONS, 2nd ed. Lawrence D. Robbins, M.D.; pub. by Springer. $50 at Amazon.Com.  It covers all types of headache and is primarily focused on medications. While the two chapters on CH total 42-pages, the actual relevant material is longer because of multiple references to material in chapters on migraine, reflecting the overlap in drugs used to treat. I'd suggest reading the chapters on migraine for three reasons: he makes references to CH & medications which are not in the index; there are "clinical pearls" about how to approach the treatment of headache; and, you gain better perspective on the nature of headache, in general, and the complexities of treatment (which need to be considered when we create expectations about what is possible). Finally, women will appreciate & benefit from his running information on hormones/menstrual cycles as they affect headache. Chapter on headache following head trauma, also. Obviously, I'm impressed with Robbins' work (even if the book needs the touch of a good editor!) (Somewhat longer review/content statement at 3/22/00, "Good book....")


HEADACHE HELP, Revised edition, 2000; Lawrence Robbins, M.D., Houghton Mifflin, $15. Written for a nonprofessional audience, it contains almost all the material in the preceding volume but it's much easier reading. Highly recommended.
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LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.

2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or ; On-line screen to find a physician.

5. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

6. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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As you read the messages, you will find your experience mirrored by many others but with sufficient variations that you will get the message--don't try and predict every step or be too surprised if you experience (most especially during the early months) is changing.

Don't fall into the trap of trying and changing treatments frequently. It takes time to try, adjust dosing, give you body time to respond, etc. before making any judgments about the success/failure of any treatment plan--why you need to work with a doc who knows their business!

I did a survey a while back on how much melatonin people were taking to prevent night time attacks. 9-12 was kind of middle of the road, with some at lower levels, and only a few at higher. Some combined the slow release with the standard release tablets, to get them thru the night. AS with everything else, trial and error are the rule of thumb.

Joe

Guiseppi wrote on Oct 8^th, 2010 at 9:34am:


Part of the board's power is in its collective wisdom. Part of the board's effectiveness is the community of fellow sufferer's who have found a camaraderie in discovering solutions to a solution resistant power. "I" am extremely glad to be part of this board, and "we" do an incredible job assisting "others" who find CHs so vexing. "We" are doing a great job, and "I" thank you. Blessings. lance