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One simple way that they differ is that while people with migraine can generally go lay down in some helpful situation (dark, quiet room, damp cloth on forehead, etc.), people with to CH are too agitated to do that (and it doesn't help the pain). Agitation -- pacing, rocking, etc. -- is a clinical sign of CH. This is pretty generally true, even in milder versions of CH. Since you say that in some situations it your attacks can last for a while, maybe you have experience. At the most basic level, medical preventives and abortives for CH and migraine are the same, so it might not matter all that much. O2, however, is generally not effective for migraine. The D3 regimen is a preventive that helps with both.

Uff.. This one made my eyes sweat a bit. Just sweat mind you! I have managed to drop down to 480 on the verap after starting the D3 reg introduced to me by some saint on here. (I had started having heart palpitations at 600) so I was happy to decrease and hasn't happened since. I just got done with a quick load D3 and things are a bit odd as I'm having spikes every day but they are so much more manageable (like you can ignore them and not rush for meds). I am now on the taper down and have a blood test kit coming to get labs to see if I reached the correct initial dosing. I only had 2 spikes today so (good day so far) trying to take things in stride and learn from folks that have not offed themselves having this much longer than me. We have a huge fire here in Unicorn land (CA) That is now only idk 7 or 8% contained and smells like I'm having a bonfire in the back yard I am assuming something is going rt with the D3 as I've only woke up screaming once this month (my worst month as far as I know)..

Thanks so much Jonathan. I’ve got a dr appt next week to see about getting an o2 canister as that seems to be the best option to bypass the triptans. I haven’t done much research on D3 but I’ll definitely check it out. Nice to get this type of feedback for sure!

Overall, I'd say you are not incurring any overuse risk, particularly if it's sumatriptan that you're using. Sumatriptan has a very short half-life, so your daily 25mg is fully out of your system before your next dose. I don't know whether you're messing with anything significant by breaking them up, but I would think not. (They do come in 25mg doses.) You are very fortunate! We rarely -- if ever; I don't remember it happening at all -- see anyone here who stops a CH attack straight off (or at all) with any dose of a triptan tablet, let alone a dose that small. Even with migraine, where the tablets are sometimes effective, it usually takes a while for a pill to have an effect.

Hi TT....welcome aboard... .... OXYGEN combined with energy drinks/high caffeine drink and the D3 regimen and you might could eliminate the triptans altogether. kinda dependent on how long your cycles last and their frequency. even with your short/infrequent cycles it would be good info in the bank for future reference....CH mutates regularly... ....for that low a dose, and an oral to boot, to be that effective as what sounds like a prevent, is most fortunate. all exceedingly rare and good on you for dialing it in like that... ....rebounds are a pretty individual dependent. generally, the higher the dose the more likely rebounds (not a given). usually reported as more frequent hits, and/or at odd times, and/or with different intensity than your typical pattern. only real way to find out is comparing a log of hits with and without triptans....tho with enough experience gut feel probably sufficient. agree with CHf as unlikely for a dose this low... best jonathan

.....different strokes for different folks.....aint no absolutes in clusterville.... .....for about 7 yrs verapamil was a relatively successful med for me....manageable side effects and knocked out about 70% of hits and seemed to make hits lesser in intensity. 5-6 cycles per yr so a prevent was critical. nothing less than 480 mg/dy worked (had to be IR)....would go to 1000+ in high cycle. heart function monitoring essential, and extra fiber/water to keep things moving along. a serious med for sure....for a serious condition. eventually got tired of the constant fatigue and being med reliant and dialed in OXYGEN/energy drinks, D3, w/Zomig for breakthroughs (rarely) for my ultimate management....w/chemo, age, and other life changes being additional factors i wonder about... .....i'd do it again if i didn't know now what i didn't know then, or what's a Clusterbusters for? but, the alternative options presented here are not always possible, practical, or suitable for all...as far as i'm concerned, verapamil is an effective prevent for a good number of folk, and remains a valid tool in the ammo belt... best jonathan