Headache. 2009 Jan;49(1):117-25.Related Articles, Links
Verapamil for cluster headache. Clinical pharmacology and possible mode of action.

Tfelt-Hansen P, Tfelt-Hansen J.

Danish Headache Centre, Department of Neurology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark.

Verapamil is used mainly in cardiovascular diseases. High-dose verapamil (360-720 mg) is, however, currently the mainstay in the prophylactic treatment of cluster headache. The oral pharmacokinetics are variable. The pharmacodynamic effect of verapamil, the effect on blood pressure, also varies considerably among subjects. The dose of verapamil used for cluster headache is approximately double the dose used in cardiovascular disease, most likely because verapamil is a substrate for the efflux transporter P-glycoprotein in the blood-brain barrier. The access of verapamil to the central nervous system is therefore limited. The clinical use of verapamil in cluster headache is reviewed and several relevant drug interactions are mentioned. Finally, its possible mode of action in cluster headache is discussed. The effect of verapamil in cluster headache most likely takes place in the hypothalamus.Verapamil is an L-type calcium channel blocker but it is also a blocker of other calcium channels (T-, P-, and possibly N- and Q-type Ca(2+) channels) and the human ether-a-go-go-related gene potassium channel. With so many different actions of verapamil, it is impossible at the present time to single out a certain mode of action of the drug in cluster headache.

Publication Types:
Review

PMID: 19125880
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This doesn't speak directely to your question but it's the only thing I have on the issue.

The date of your report should make the information suspect and, therefore, the conclusion. Changes occur so rapidly in many areas of medicine that speculation of this age may be only of historical interest. ?????

Verapamil is, however, a substrate for the efflux transporter P-glycoprotein (P-gp) in the blood–brain barrier.

Cluster headache is associated with abnormal diurnal rhythms of hormones such as cortisol, testosterone, growth hormone, and endorphins.

Verapamil blocked P- and at higher concentrations possibly N- and Q-type Ca2+ channels. The human T-type calcium channel is also blocked by verapamil.

HERG potassium channel blocker.  It is possible that verapamil also acts on HERG potassium channels in the CNS.

In conclusion, the possible modes of action of verapamil in cluster headache are legion but most likely due to an effect on either the low (T-type) or the high voltage-activated Ca2+ channels (L-, N-, P, Q-type). Although generally described as an L-type calcium blocker, verapamil has possible effects on a range of other Ca2+ channels present at the most likely pathogenic center, the hypothalamus. At this point, we are thus not able to point to a specific action underlying the efficacy of verapamil in cluster headache.



A direct impact of magnesium on the function of the efflux transport protein P-glycoprotein at the level of the blood-brain barrier has also been demonstrated:
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Magnesium blocks L-type calcium channel and N-type channel:
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Magnesium blocks L and T-type Ca2+ channels:
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Mg2+ exerts a direct action on HERG potassium channels:
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Magnesium is a critical element in 325+ biochemical reactions in the human body.
Recent research, in France and several other European countries, gives a clue concerning the role of magnesium plays in the transmission of hormones (such as insulin, thyroid, estrogen, testosterone, DHEA, etc.), neurotransmitters (such as dopamine, catecholamines, serotonin, GABA, etc.), and minerals and mineral electrolytes. 
This research concludes that it is magnesium status that controls cell membrane potential and through this means controls uptake and release of many hormones, nutrients and neurotransmitters. It is magnesium that controls the fate of potassium and calcium in the body. If magnesium is insufficient potassium and calcium will be lost in the urine and calcium will be deposited in the soft tissues (kidneys, arteries, joints, brain, etc.).

Magnesium protects the cell from aluminum, mercury, lead, cadmium, beryllium  and nickel. Evidence is mounting that low levels of magnesium contribute to the heavy metal deposition in the brain that precedes Parkinson's, multiple sclerosis and Alzheimer's. It is probable that low total body magnesium contributes to heavy metal toxicity in children and is a participant in the etiology of learning disorders.

Is Verapamil a mimic of Magnesium? As Calcium channel blocker, YES

nhs wrote on Dec 13^th, 2011 at 4:44pm:


This rang a bell, apart from the topic.

I don't have it anymore, but in 2003 I read a study from Milan about isolating genes and clusters.  They printed results on a possibility of something found in chromosome 1 (ATP1A2) with cluster patients: A malfunction of the pump which shifts NA and K through the cell.  Difficulty in shifting NA out of a cell would cause it swell.

Also brought to mind any relationship in anti-inflammatory and "swell".


It's a different angle, I haven't paid attention to any follow-up.

I take 6000 IU of vitamin D3, and 1000 mg of mag a day and it's been a real nice PF ride.

Focus...
Coach Bill