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How Do You all Stay Happy People??


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Hydroxyzine is a far more potent and cheaper (if you have good insurance) method to the antihistamine approach if you follow. It is a second generation H1 antihistamine. Benadryl is one way, this a cheaper down and dirty method than the H1 target approach that people think of.  The first generation H1 Antihistamines are the ones legendary for all the problems and include clozaril and amitriptyline. 

I think the first generation broke the blood-brain barrier, the second doesn’t. The only one of the second gen worthwhile is Hydroxyzine, the rest like Claritin serve no purpose.

Its straightforward. If you want to really not pass go take a Haloperidol 

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Also @BoscoPikoand @Shaun brearleyI am not smart. If I was, I would have attended an A list university such as Emory or Washington University, soft Ivy League like Johns Hopkins, or Ivy League such as the Wharton School of Business, as all of my past friends did. I attended flipping University of Baltimore on full scholarship as an honors student. The only thing it is known for is its top 20 law program, national best taxation program, and in undergrad the Urban Development and Economic Planning program that I was involved in, and Accounting. I was a dual major.

The point is I am just average at best. I think that I read things properly and am desperately trying to communicate properly with others.

If anything, with the medical and all research, it is a matter of just taking your time, filtering the important and relevant information, and then processing it. It appears overwhelming, but you can easily go thru a few thousand pages per day if you learn how to properly skim said information and find what is pertinent. Honestly, purchase a medical dictionary, be patient it isn’t anywhere near the perplexity one makes it out to be. Cogito Ergo Sum. 

It isn’t like reading a classic such as Dosetstchesky or a great post modern by DeLillo. Respectfully, this isn’t an attempt to understand Kant’s deontological ethics, or even more obtuse Tractus Logico-Philosophicus by Witttengstein. 

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I'm not a doctor, but severe withdrawal and grand mal seizures can occur with abrupt withdraw.

I don't know your dosage but you need to taper anywhere from two weeks, up to two months. Say that you are on 100mg you would probably taper 25mg at a time. I've never been able to stay on top of the damn metric and imperial shit, but I believe you use milligrams. Please excuse my ignorance. 

I would not trust my advice, but start with 25mg for two weeks, then go down another 25mg, and keep dropping. Never stop an antiepileptic cold turkey. I've read of crazy, awful shit happening. And I don't think that they allow Benzo use in the UK, I know that Halicon got banned in the 90s, but that is a prime example. I spent 6 months tapering off of the Benzo Lorazepam, had seizures all the time, was violently ill. The point, it can (I would go as far to say) kill you if you just quit without titration. These aren't lightweight drugs. 

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You are welcome. If you feel a bit off, go back to the norm. If fine, start over. It has propensities to be a tumultuous, taxing process.

In a cruel twist of fate, and this is how I know that I am not smart, the medicine won't help while you take it, but coming off-be prepared for the worst headaches of your life, and I don't know why. Someone a lot smarter than I am will have to explain how that works. You will most likely get some nasty headaches that will have you screaming bloody murder. 

Second, I added in the Benzo use because that class of drug, in conjunction with the antiepileptic (anti-seizure), is super nasty to come off of. Certain psych meds as well, but the aforementioned can have you come close to needing a chemical straight jacket, i.e. a potent neuroleptic. 

I know everyone knows what CSD is, neuroanatomy 101.  I thought that the following articles on Cortical Depression Spreading were necessary, and if you pay attention to the Ca+ waves, it makes sense why Toprimate is efficacious in Migraine, why it can prevent or reverse chronicity. Toprimate targets the Calcium Channels, but not like a blocker say Verapamil. I know, everyone knows this: I will post for those that don't. 



How does this help you? Well, unfortunately, about everything starts with Migraines, and CH--the redheaded stepchild--follows suit. I will have to look at the latest neuroimaging journals and see what is in the pipeline for CH. There is far more than people realize. 

Oh, and yes, these are old journals, but sometimes they are reliable. People make the mistake of thinking that the latest, is the greatest. And then, they fail to realize that so much of what is available today is questionable, ghostwritten, sponsored by someone such as Lilly or Pfizer, good luck discerning fact from fiction. 

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While not intentional, I understand considerably more about the pathophysiology of migraine than CH and feel that neurologists and scientists have a solid understanding of migraine pathophysiology. From such knowledge, they can begin to develop drugs to treat it.

They say that drugs take a decade to develop, but correct me if I am wrong I thought more like 20 to 25 years. For example,  Divalproex Sodium, developed in the early 1970s, didn't gain a patent and come to the U.S. market as a mood stabilizer for Manic Depressives- excuse me I’m supposed to call it by the Orwellian Post Modern Bipolar Disorder-until 1992. By then, it was intended as an anticonvulsant.

I have several other examples, some took 30+ years of development. That, or they sat on the shelves, gained new life, got some half cooked theory that they could work, and with brilliant marketing were turned into blockbuster multibillion dollar drugs. It’s best that I keep my mouth shut.

Now to throw a wrench in this, they have known for considerable time about the Trigeminal Autonomic Cephalalgias role in CH, and now they found a link with, guess what, CGRP a few years back. The pathophysiology of CH is not intended to be esoteric by a group of intelligentsia (Top Neurologist); rather, it is that clandestine. Further, they aren’t attempting to be debonair about this, it is f#%ing complex and confounding. 

Here is one-of many-links to reputable journals of the pathophysiology of CH. Change is coming, and if you read my following posts, it takes time for drugs to develop. Fast tracking a CH drug doesn’t have sex appeal like an Alzheimer’s drug. Right, we can fast track drugs and knock quite a few years off the process of approval in this country. Truth is they do this already, it is called cronyism, again, I better keep my mouth shut. Here is a link.



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Here is an update on Pathophysiology:


You want to follow Dr. Goadsby’s Work. I consider him the expert not only on CH, but on Migraine. I have limited access to JAMA, Science, Nature, Lancet Neurology (anymore, and sadly), and that is where you find his work. He is the rock star of neurologists. I did find this 70 page, relevant journal on the pathophysiology of migraine from 2017


Here is a 2017 reputable and relevant journal on the pathophysiology of episodic cluster headache


You will have to forgive my ignorance, as I have not followed this revived antiquated idea, neuromodulation. This has been used in some semblance for centuries, and now is under extensive testing for CH. I am a wait and see type of person, after the deleterious and abhorrent side effects of ketamine infusions which fomented a 6 year span of debilitating end-stage catatonic depression. Here is a current article. My current psych NP’s exact words in reference to the Ketamine was “they gave a manic depressive with known SI Ketamine, did you sue them?” Yeah, know one discusses the dark side of said drug.


Migraine and Cluster Headache- The Common Link


Review of Device Therapies for Migraine and Cluster Headache



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@Shaun brearley I think across the pond it is called a GP? Give this to your GP, if you are lucky your Neurologist. This is the most recent guidelines in pharmacotherapy for Cluster Headache. In other words, which medications to prescribe. This was released to the doctors a year ago. Dr. Goadsby was one of the authors.

Pharmacotherapy Cluster Headache



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This one is important: as we know, CGRP targets don’t break the blood brain barrier limiting treatment options. This journal presents a future targeted approach towards treating Migraine. Again, with treating migraine comes CH treatment and they do have a symbiotic relationship. This appears a target approach to CH in future years.

Electrical stimulation of the superior
sagittal sinus suppresses A-type K+ currents and increases P/Q- and T-type Ca2+
currents in rat trigeminal ganglion neurons


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Please read this and be patient; I have followed and suspected inflammatory markers through cortical spreading and  neuroinflammatory signaling for years. This journal is one of a few that supports my gumption. That is most likely why Vitamin D, and EPA/DHA have such a profound impact. Most say”oh that is for Migraine.” I roll my eyes. It all follows. Cut the f$&ing shit.

Parenchymal neuroinflammatory signaling and dural neurogenic inflammation in Migraine 


You should certainly be staying curtain on this one, as autoimmune and CH in men are hand-in-hand, as are psychiatric comorbidities. It’s not rare to have all three, quite prevalent and most are not aware. This is a jackpot find of a journal. I mean, it’s easy to find journals, but finding the ones through structured searches rarely pans this out.

 Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms


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Here is more for you to consider and something else that I followed for over a decade, low testosterone and androtestoterone. I had low T and used DHEA, among other things to jack my Testosterone up. My blood levels confirmed the raise. My headaches dropped significantly. To be fair, my doctors don’t question my motives or why I ask for specific blood/lab draws. They already know what in the hell I am up to. Lol. Getting insurance to cover, and methods of coding, yeah that takes a monumental effort on all of us and how to manipulate the ICD.

Clinical Symptoms of Androgen Deficiency in Men with Migraine or Cluster Headache 


Be sure to print out the pharmacotherapy guide. That will help you with treatment. Dr. Goadsby is the forerunner on all headache prevention and treatment.  

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