I don't use verapamil so I can't help you there. I will tell you one of the most frustrating aspects of the beast is his ability to constantly morph. Figuring cause and effect can be such a challenge. Did the meds extend it? Did the cycle just morph?

Joe

It's too easy to assume too much based on one experience in a test animal (us) where variability is the norm.

Don't be impulsive in making decisions about the treatment plan.

EVAN:

Your last comment captures the dilemma of: A. how to evaluate changes in our cluster situation, B. the meaning of relationships—if any—between 2 or more events. Here, talking about changes in the use, frequency, dose and the effect of adding a second  med or treatment OR some combination of all these variables.

A major player in this picture is our mind’s operations. We are motivated to explain/understand important events. It’s ease to quickly link two or more events and to assume we have a correct explanation for our concern. The next step: hold onto the explanation and lose sight of how weak our evidence often is.

Changing important beliefs is hard—because they are important to us—and this, most especially, when the data are soft, e.g., politics & religion.

Simply put, in your situation, making meds changes, dosing, frequency, etc. introduces more variables than can be evualted re.the end results.

Confounding your issue: is the issue recurrence of an attack or a rebound attack? Or, as you suggest, the ending of a cycle? Add, the absence of evidence that Verapamil causes rebound and the mixed evidence that Imitrex consistently causes rebound.
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(First posted a few years ago.)
Rebound headaches. "Rebound Headaches--A Review", Au. John S. Warner, M.D., in HEADACHE QUARTERLY, 10:3(1999). (There is some confusion on the board about the meaning of "rebound". There appears to be an emerging consensus in the medical literature to define "rebound" as a headache which is caused by the overuse of any medication used to abort a headache or relieve pain. "Recurrence" [of a headache] is being used to refer to the redevelopment of an attack when its "normal" duration is longer than the useful life of the medication which has been taken. That is, the medication effectiveness is reducing before the headache has come to an end; the pain redevelops.)
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Sumatriptan has a hard initial punch and relatively short effective life--a combination which works well for most Cluster attacks. However, some people, whose Clusters have a longer life, find that the med is wearing down even as the pain continues. One can understand how this sequence comes into one's thinking: Attack, Imitrex injection, pain continues, it's a rebound cluster which has developed from the Imitrex. In fact, this is a recurrence of the attack, not a rebound.

This is one of the reasons that several other triptans were developed having less initial punch but longer effective life. While aimed at the migraine crowd, at first, a number of cluster users have found this characteristic of value to them.

Evan: sorry that my writing style came across as a accusation or declaration about rebound with triptans, etc. Read it as an overview statement vs. your specific use/conclusions.

I, too, have reports about he potential for rebound with triptans. The medical position has clearly changed over the years to admit the possibility. But stuff I have suggests the rate of rebound is quite low compared to OTC pain meds.

At the core of my comments is a concern--of importance on this site--is how readily folks leap to conclusions about the impact of a med, changes in symptoms/response, etc. In the years I've been around here I've come to the conclusion that misuse (broadly defined) of meds is a greater problem than the actual side effects of the meds themselves.

It's useful to be confronted with challenges to our "expertise" <bg>. 

I had to catch my breath after reading:

Headache. 2011 Nov;51(10):1546-8.
Sumatriptan in excessive doses over 15 years in a patient with chronic cluster headache.
Kallweit U, Sándor PS.
SourceFrom the Department of Neurology, University Hospital Zurich, Zurich, Switzerland (U. Kallweit and P.S. Sándor); Department of Neurology, Kamillus-Klinik, Asbach/Ww., Germany (U. Kallweit); Department of Neurology, ANNR RehaClinic Cantonal Hospital, Baden, Switzerland (P.S. Sándor).

Abstract
We report the case of a 49-year-old lady with cluster headache, who had received sumatriptan s.c. treatment for 15 years with daily dosages between 12 and 222 mg (average of 150 mg during the last year). The therapy was successful in aborting CH attacks. Long-term overdosage of sumatriptan was well tolerated, without adverse events.

© 2011 American Headache Society.

PMID:22082424[PubMed]

Bob Johnson wrote on Jul 22^nd, 2012 at 3:18pm:


Wow, assuming she is using 6mg a time, that is between 2 and 37 injections a day with an average of 25 a day! That is one incredible amount, never mind the cost!

I wonder if she has ever tried oxygen to abort?