Posted by Doc Greg on October 30, 1998 at 18:34:14:
In Reply to: Now what?!! posted by Jim on October 29, 1998 at 20:17:48:
Jim
Some excellent replies from already, but I will add a couple of things.
O2 at bedside is an excellent treatment of the acute attack...but my problem has always been that once I take off the O2, the headache comes back...keeping me on the tank for 3 hours at a time. Migranol (the nasal spray of DHE) is another possibility for the treatment of your cluster...sometimes effective even when Imitrex is not.
You should absolutely look into ways to end/reduce the cluster. Prednisone burst (mentioned already) is an excellent way to go. It is most effective at the beginning of a cluster...but always worth a try. Verapamil, Lithium, or some of the ergots are also possibilities.
There is nothing documented about water therapy that has been mentioned on this site several times. When tried in moderation, it is probably safe to try...but one must be careful of not losing all of the salts in your body by drinking large amounts of plain water. The kidney is not capable of producing pure water urine...and so salts are also secreted. If you drink enough water, you will deplete the body of sodium, potassium, and chloride to the point that it could be very toxic. It does take a lot of water, but just be careful...and tell your doctor that you are doing it so he can check you once or twice to make sure everything is ok.
The antifungal theory is very interesting. The problem is that a lot of the antifungal medications can have bad side effects on the liver...so I would not freely prescribe this until I learn more. It could well be related to fungal infections, though. If you do try it, your doctor will need to check your liver enzymes periodically during your treatment. (antifungals often need to be taken for several weeks to be effective depending on the location of the fungus...and who knows where it is for a cluster headache sufferer).
Good luck
Greg