Posted by pinksharkmark (196.3.74.234) on July 15, 2000 at 11:22:55:
In Reply to: The Demon lives again!! posted by Kyle B. on July 15, 2000 at 10:14:00:
Right at the top of the page is a link to a very good article detailing treatments. It has the word "FANTASTIC" in red, and then a "click here" link in blue.
The preventive that seems to work for the highest percentage of people is Verapamil, a calcium channel blocker medication that is also used in treatment of high blood pressure. It is a very benign drug that can be taken for long periods of time at the high doses necessary to bring a cycle to a close and prevent a new cycle from occurring. Typical doses for clusterheads are from 240 mg to as much as 960 mg daily. Your doctor, preferrably a neurologist with experience treating clusterhead patients, will decide if it is appropriate for you and will determine your starting dose.
The abortive (a drug that terminates the headache once it has begun) that seems to have the highest success rate for clusterheads is sumatriptan, sold as "Imitrex" in North America and "Imigran" in Europe. It is available as an injector, a nasal spray, and an oral tablet. The injector works fastest, typically in about five minutes. The nasal spray takes a little longer, and the tablet can take as much as an hour to work. The injectors are the most expensive, the tablets the cheapest.
Imitrex can have side effects on some people with certain heart conditions. A newer "triptan", called Zomig, works at much lower doses and is claimed to have much milder cardio-related side effects, although it is still not recommended for those with certain heart conditions. At present it is available only in tablet form.
There are other treatments as well, most if not all are described in the link at the top of the page.... Sansert, Cafergot, Indomethacin, Dihydroergotamine, capsaicin cream... there's a whole bunch.
The reason I mentioned the Verapamil and the Imitrex/Zomig specifically is that these two, along with oxygen and prednisone, are considered the "front line" treatments, i.e. the ones with the highest likelihood of success, and I didn't see either one in your list of things you have tried.
If you go to your neurologist armed with this info, you and your doc can make an informed decision about what should be the next step.
Sorry to hear you are in such a bad state. I can sympathize... my current cycle started teasing me in mid-January, got serious in mid-February, and escalated to four CH's per day mid-June. Still going strong... no end in sight. My girlfriend tries to understand, but she's getting pretty sick of the whole thing. As she says, "I want my sweetie back!"
I kiss the feet of the research team that developed Imitrex, though I curse the heads of the marketing department gurus who keep the price so high. Unfortunately, I seem to be one of the people for whom Verapamil doesn't work. It worked once many cycles ago... broke the back of the beast in about two weeks... but it has never worked for me again. Sigh.
Best of luck to you
pinky