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Rebound Headache


Ouelmath
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Hello everyone,

I'm suffering of Cluster headache since 15 -20 years. About 10 years ago I was diagnosed chronic. I also have regular migraines. I'm in a crisis since one and a half year. I take intranasal Zomig 5mg 2 times a day since then. Actually, I think I may have rebound headache. Does anyone of youguys ever had rebound headaches? I'm trying to avoid taking my Zoming but my headaches are too strong. The are less strong then Clusters but almost as strong. Are rebound headaches suppose to be that painfull?

By the way, i'm french so sorry for the poor writting.

Thanks!

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Rebounds are pretty common with this category of Med.  the whole triptan family is notorious for rebounds and extending cycles.  Indeed they are a necessary evil but investigate oxygen and alternatives here.  Read Bobs summary of the condition and treatment options then bring the questions.

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Many people who come here really desperate find that "busting" (taking psychedelic substances, sometimes in doses small enough that they do not cause a "trip") is the answer to their prayers.  You can read about busting in the numbered files in the "ClusterBuster Files" section.  What might be the hard part for you is that you should stop taking triptans for five days before busting.  We can discuss this more if you decide that you want to try busting. "Truffles" from the Netherlands have proven to be quite effective for busting.  Busting has helped many people with migraines, too.

Meanwhile . . . Do you have a preventive medication?  Usually that's a calcium channel blocker called verapamil in the US -- and usually it has to be taken at higher levels than many doctors prescribe in order for it to be effective.   Have you tried quickly drinking an energy shot such as 5-Hour Energy at the first sign of an attack?  If you are able to get melatonin (it's available openly here, but I think only by prescription in Europe), 9 mg at night, or more, can be very helpful.  Magnesium can help (that is mentioned in Bob's paper; I'm not sure of the dosage).

Some people find that if they stay on the oxygen after an attack has been stopped, for about 10 minutes, it can hold off future attacks.  Oxygen when used in conventional ways is most effective if the flow rate is at least 15 liters per minutes, and if you have a mask that is made for people with CH.  You probably didn't have either of those things the last time you tried it.  There is also another method for using oxygen that we can tell you about if you get that prescription.

Finally, I would suggest that you look at the list of "triggers" in the ClusterBuster Files section.  It is possible that you might notice something there that is making your situation worse.

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Actually, I tried psychedelic mushroom only once. But like you say, I have to stop triptans for 5 days and just can't.... I have read that I have to stop Verapamil for 5 days also. Never tried Energy drink. I'll give it a try. Melatonine is open prescription here (Canada) but don't really do nothing for me. Actually for prevention I take 480 mg Verapamil twice a day, novo divalproex 1000 mg twicw a day and 75 mg lamotrigine twice a day. When I'll get my oxygen,, I'll ask for a CH one. Before I was using a regular mask. I'm just reading the D3 regimen you are talking about. I'm seeing my neurologist next week and talk to him about that.

Thanks for you're precious tips!

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Sorry you are taking all that stuff.  The side effects must be unpleasant.  (It's my very vague understanding that sometimes lamotrigine increases the side effects of divalproex.)  It's good to ask your neurologist about the full D3 regimen.  If there is a specific interaction with your current meds that he is concerned about, that is important to know; if he freaks out about the large amounts of d3 just in general, as some doctors do, I think you'll have to make the decision on your own.  As far as I know, no one has had bad effects from that much D3, as long as (1) they are taking the full regimen, and (2) they have blood tests to make sure that their D levels don't eventually get too high.  You'd want to take the calcium part of the D3 regimen 6-8 hours apart from verapamil (because verap is a calcium channel blocker).

You will probably have to order the mask separately.  If your doctor is highly sympathetic and if it's possible in Canada, you might try asking for a demand valve system for your O2.  If you want to order a mask now, it's at http://www.clusterheadaches.com/ccp8/index.php?app=ecom&ns=prodshow&ref=clustero2kit

We just had a report from a person having very good results with another approach to using oxygen.  If you type the phrase "red neck" (in quotes) into the search bar at the top of the page you will see posts about that method, which doesn't require any fancy equipment.

We have found that it's not necessary to be completely off of verapamil in order for busting to be effective, but I don't think anyone knows what applies at 960 mg/day.  Sounds like your doctor is really trying to help you and more or less knows what he's doing (as much as anyone does when treating CH).  If you think busting might be something you want to try, I guess you'd have to look at all the meds you're taking, and I'm lost there.  I can say that for some people, having a good O2 system, having the D3 regimen kick in, and using energy shots makes it easier to get off the necessary meds enough to try busting. (And it's also not completely unusual that when people stop the triptans, their headaches become less bad, probably because of the rebound effects you have mentioned.)

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Quelmath please up your game on the oxygen. Try the method CHf mentioned. Do not get hung up on the lpm. I "pussyfooted" around this for a while with marginal results. For me the rapid oxygenation of bloodstream was what helped me to kill attacks(sometimes in 5 minutes) work best and staying on 5 minutes after relief of pain to prolong next attack. Oxygen is the best abortive but it won't stop the cycle, there is plenty of info here on how to do that. PF and good luck to you. 

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