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Update: This has continued to be effective, but he was still having occasional less severe attacks, especially when the weather changed which has been happening a lot recently where we live. Added Quercetin twice daily to the schedule about 10 days ago, seems to have helped even more. Only one attack since then. He’s even been able to have a couple beers without a headache which has previously been unheard of.

I'll be interested in how the continuing research shakes out regarding psilocybin and PTSD, since I've been reporting for quite awhile that I credit Vitamin M busting with pretty much entirely quashing my previous PTSD-like dread of CH, and I hope others could receive that additional benefit from their busts https://www.thehealthy.com/mental-health/magic-mushrooms-psychedelics/

Well I've had CBT and I've got to say it didn't work for me as I wasn't will to talk about what I did or saw whilst in the military which caused my PTSD ,I have really bad nightmares which I call horrormares , I have done for over 20 years know It caused the break up of my first marriage .I will say that since I've used vitamin L the horrormares have subsided not completely but they have calmed down . My mental health nurse has said she has noticed a difference in me and top me to carry on with what I'm doing . I did explain to her that I was using it to treat my CH , but as she said it's also helping with my PTSD

Another in the seemingly constant stream now of psilocybin trials for PTSD, depression and stuff (alongside any currently underway specifically for treatment of CH): "Magic Mushrooms Are Safe to Treat Mental Health Conditions, Says Another Landmark Trial."https://www.goodnewsnetwork.org/magic-mushrooms-mental-health-the-journal-psychopharmacology/ "A trip to the doctor for a dose of magic mushrooms could help treat mental health conditions like PTSD, according to new research. Small doses of the psychedelic drug psilocybin, found in magic mushrooms are not only good at easing disorders that are resistant to treatment, but they also have no short or long-term side effects in healthy people, scientists say."

In short, High dose prednisone 60-100 mg a day for 2-4 weeks can help especially in an episodic situation while other modalities kick in. It can also help with getting some sleep if one gets strung out on nocturnal attacks. Many docs prescribe a dose pack which is a burst dose with quick taper commonly used for back pain. This may have short term help but its not enough for cluster headache in most cases. Of course there are costs with the benefits. Prolonged steroid use can suppress the adrenal glands and it might be a struggle to get them back in sync. The more feared side effect is aseptic necrosis of the hip. This is a situation where the blood supply to the hip joint is occluded with small fat emboli and the bone dies and the joint needs replacement. Unfortunately this situation is not dose dependent and unpredictable when it might occur. On the flip side many many folks need steroids for a variety of conditions and tolerate them just fine. Long term steroid use can cause other issues so its not practical in our situation. The most common side effect is agitation and short temper especially during withdrawal.