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Yes, Pebbles', I tried "contributing" at the FB group, and found the mixture of assertive opinion and actual knowledge to be something I couldn't handle. It serves a valuable purpose, though. There are least three people there who used to be substantial contributors here who have found very substantial relief with DALT, while on the other hand some here did not get relief from DALT. Other things for Tim: Yes, D3! https://clusterbusters.org/forums/topic/1308-d3-regimen/ Some people find that sleeping more upright -- in a recliner or even at a table with your head on pillows -- helps with nighttime attacks. An energy shot such as 5-Hour Energy, drunk at the first sign of an attack can reduce or even abort an attack. Many people prefer them icy cold. You might want to take more melatonin. Some people go as high as 30mg. It's quite a cocktail you're taking at night, so I suppose you have to be careful about what you add to it. Generally, 12mg/day of Imitrex is considered a "safe" dose. But it has side effects, for sure, and there is research showing that sumatriptans cause rebound headaches and extend cycles. Oxygen is your way out, as we have said. I don't think the Xanax is helping with your attacks. Many people have found that skullcap is more soothing and less harsh than Xanax. You can find it as homeopathic drops or as a tea. You might be taking the propranolol for some other condition. I don't think that beta blockers like that are as effective for CH as calcium channel blockers such as verapamil, though both treat hypertension. The darn thing about lithium is that coming off it causes rebound attacks for many people. That's one reason why it is mainly recommended for people with chronic CH. I'd really consider trying the oxygen, D3, and maybe verap before stepping up the lithium.

Hi Tim Oxygen used correctly will eliminate the need for trex for many folks....I've used one injection during the course of my last 3 cycles (6 years).....I routinely abort hits in 5 to 8 minutes using only O2 and coffee.....my experience is that trex causes rebound hits and extends cycle length. Dallas Denny

Sounds like CH. Could be something else, but you should treat it as CH. I take it you mean 25mg of prednisone twice a day. Typically 60mg/day is the max (or less, if you don't weigh much), and that's just for a few days before tapering off of it. Try to get an appointment at a headache center! And yes, they might come back as you get off the pred. Pred can be really bad for you if you take too much for too long; usually it's used as a "bridge" to help with the pain while you start other treatments. Okay, there are tons of things you can do. The most common pharmaceutical treatments are verapamil as a preventive and OXYGEN as an abortive. Oxygen is the #1 thing you want. Read this: https://clusterbusters.org/oxygen-information/ Sometimes sumatriptan injections or nasal spray are recommended as abortives (called Imitrex in the US). But GET OXYGEN (a competent physician can prescribe it). Start the vitamin D3 regimen right away: https://clusterbusters.org/forums/topic/1308-d3-regimen/ Try an energy shot (such as 5-Hour Energy) at the first sign of an attack. Many people prefer it very cold. Drink it down. Melatonin at night helps some people. Start at 9 mg. Once you have tapered off the pred, you could be in a very good position to "bust" -- to take psychedelic substances to end your cycle and possibly prevent future ones. Some of these substances are illegal to buy or possess and might cause you a significant "trip"; others are legal to buy and possess (but not to consume) and will cause practically no trip. Read the numbered files in the ClusterBuster Files section of this board, and get back to us if you are interested in knowing more. Others might chime in with their own advice for you. CH is a crappy thing to have, but you can learn to manage it and maybe even do better than that. Here's a lengthy discussion of options and new developments from the founder of ClusterBusters: https://clusterbusters.org/forums/topic/4567-bobs-big-pocket-guide-to-cluster-headaches/