Posted by Robert Krause on May 19, 1998 at 12:28:49:
In Reply to: Verapamil & Prednisone posted by Ken on May 18, 1998 at 19:33:47:
I have very good experience with Verapamil to
prevent cluster attacks. But I don't take it all
the time - only for the duration of an episode.
When I get the first attacks of a new episode
(usually not that bad) I start with 120mg for two
days then 240mg for another two days and 360mg
from then on. During the first week I usually get
one or two attacks but then there is at most just
the feeling of an upcoming attack for a few
minutes. When I don't even have this feeling for
about two weeks I can assume that the episode is
over and I reduce the Verapamil in steps (same
amount and duration as at startup, just reverse).
So I take Verapamil only for 4-8 weeks once or
twice a year. Side effects are minimal: slow
digestion with moderate constipation (leading to
an increase in weight). And when I take the pills
with strong coffee my heart starts pounding. But
this is nothing compared to the positive effect
of preventing the cluster attacks.
Only once - two years ago - Verapamil didn't help,
but I'm sure it was my fault because I only took
120-240mg a day. After a few weeks of increasing
cluster activity even raising the dose didn't
help anymore and I was put on Lithium for 6 weeks.
This stopped the episode and I didn't have one
for a whole year, but Lithium has serious side
effects and isn't an easy drug.
I never took Prednisone, so I can't comment on it.
My doctor always tries to give me some Ergotamine
to prevent the attacks until Verapamil kicks in.
But Ergotamine causes me heavy nausea - all the
time. So I prefer to take the risk of an attack.
Btw. my doctor is an internationally acknowledged
headache expert (Dr. Pfaffenrath, Munich). It took
me 15 years to find, but for 8 years now -and
with his help- my view of cluster changed from
horror to nuisance ;-)
All the best to you,
*Robert