Posted by Laurence (194.69.100.127) on August 18, 1999 at 14:00:19:
In Reply to: lithium, prednisone posted by odilon marcenaro on August 17, 1999 at 20:38:59:
Hi Odilon,
I have experience of both Lithium and Prednisone. Lithium worked for me in my first two cycles. It took a week or so to kick in (dosage level 1200 mg). This level was built up to over a week or so starting out at 800 mg (one 400 mg tablet in the morning and one in the evening with meals) then rising to a 3rd tablet at around lunch time. The main side effect I experienced has already been described by Dave W, i.e. you can get some shakiness. The trouble with Lithium is that you have to have a blood test after a week or two to make sure that your body (liver and thyroid) is dealing properly with the drug. Apparently it is but a small difference in going from a therapeutic level to a toxic level of Lithium in the blood. In my first cycle I got up to 1600 mg (4 tablets) of Lithium, with monthly blood tests, before the clusters abated. I then reduced the Lithium dosage back down to 1200, then 800 for a couple of months and finally 400 mg for another month or so.
In my third cycle last year, the Lithium didn’t seem to be doing the trick after a couple of months and the neurologist prescribed Prednisone - a two week course – I’m afraid I can’t remember the precise dosage now. I also continued taking the Lithium. I had no problem with Prednisone. The side effect I experienced was a feeling of euphoria! As booze was out with clusters, the Prednisone was an unusual and unexpected “substitute”. Prednisone certainly stopped the most painful cluster attacks but I had the shadows for several weeks after the course of treatment.
My neurologist suggested that if the clusters came back this year (and fortunately it looks as if I’m going to miss out!) then I should consider a course of Verapamil and, if necessary, topped up as it were with a short course of Prednisone. Verapamil is certainly a far safer drug to take, for most people, than Lithium or Prednisone. I took Verapamil for a couple of months in May and June of this year when it looked like the cluster was about to strike, but whether the drug worked, or this year was just not my cluster year I don’t know.
Given a choice, if you have it, I’d consider trying Verapamil before Lithium and either of them before Prednisone. But if it hurts like hell for too long, then take the Prednisone and if you are really lucky it will work for you with the added benefit of a real “high” for a couple of weeks.
Laurence