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I get almost daily cluster headaches (for past 3 years) and have been prescribed naratriptan (2.5mg) and verapamil (240mg). Because of the danger of heart attach or stroke from naratriptan (insurance companies will only cover 8 to 9 pills per month), verapamil was added to help decrease the headaches thus lowering use of naratriptan. The problem was the verapamil caused side effects: weight gain, swollen ankles and feet, lethargic feelling, and even a bad vaginal odor. I was slowly weaned off the verapamil, but the cluster headaches then increased in frequency, thus the treadmill of taking more naratriptan became necessary. 

The naratriptan works very well, but I cannot get enough pills to cover the number of headaches I get. And as I get adverse reactions from drugs, I don't want to take the more extreme medicines sometime prescribed for cluster headaches (those for seizures and depression are sometimes used and oxygen works only temporarily).

My question is is there something that can be done to eliminate the side effects I got from the verapamil, especially the rapid weight gain and swelling?

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I have suffered with cluster headaches for three years now. I use sumatriptan as soon as I recognise one on the way. Yes, the problem lies in how many the doctors will let me have but I have learnt to use a 1/4 of 50mg tablet and then take another 1/4, 1/2/ 3/4 if necessary about 15mins into the attack. I do not often need the 50mgs they have prescribed and thus double or quadruple the number of doses ....... hope this helps?
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Since your message is from a year ago, you may well never read this. If you are seeing this now: Firstly I'd like to say emphatically, that I sincerely hope you're feeling better. CH torture, is unspeakable to those who don't have them. I am fortunate enough to get them episodically, and rarely have more than two attacks a day. With months of remission. I've been getting them for about 15 years. I wish I could offer helpful advice, but I doubt I can tell you of any treatment you haven't heard of. For me Sumatriptan 6mg injection is the quickest, works within 5 minutes usually! Many are not so well fortuned, but I guess injected drugs are the quickest root to kill the pain.The drawback is this medicine is very expensive in the UK and USA. We can only have 2 injections in 24 hours. In Spain Sumatriptan is a 6th of the UK price! I am distrustful of Verapamil and I think some doctors(and over zealous neurologists) push it too zealously. I'm sorry to read you had an unpleasant time of it. CH sufferers are prescribed a massive overdosage of it. And if we happen to be in that significantly high minority that have potentially fatal side-effects ... No thanks. Some have needed pace-makers installed. powerful opiates may nullify the pain for more CH sufferers than Medical Propaganda will admit to for obvious reasons, but then there is the very real problem of addiction, over usage and then comes tolerance rendering them useless. Not commendable! However if all else fails? For those who have multiple attacks and or suffer chronically 24/7/365. I'd try anything. Like you I hope they come up with something specifically for CH(without dangerous side-effects), that can permanently suppress the CH attacks. Yes, I won't hold my breath waiting. I appreciate that this may seem silly to the understandably sceptical, but Cranial Osteopathy has helped reduce the frequency of my attacks considerably. I'm sure it's helped me. Apparently Acupuncture too has worked for some. Cluster Headaches are not in the same league as Migraines (they're still awful too). I'm sure there are many important factors I'm unaware of. Worth doing a lot of research. I take Magnesium, Vitamin D3, & L-Tyrosine, on a daily basis. I can't affirm that it really helps, but nonetheless I consume them. All kinds of Drugs companies, Health professionals can exploit us (the unethical ones, I'm afraid there is more iniquity out there, than I'd like to imagine). I sincerely hope that you're doing alright out there Henley. I had an attack this morning, so I scanned the web for info on Verapamil. I came across your message and felt compelled to write this long winded response. Sorry for boring you. I wish you well, health,wealth,enjoyment, an end to your pain, and the best the world has to offer.

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That is exactly what I do too!

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I would take the Sumatriptan immediately the attack commences - 15 minutes is a Long Time with a Cluster headache! . According to the Medical Formulary: One can take up to 300mg of Sumatriptan Tablets in 24hrs ( 3 doses of 100mg) . Unfortunately they are too slow for me. You can get Sumatriptan in nasal spray too.

Sumatriptan Injection is by far the quickest root to stop the pain. It works for me within several minutes. Unfortunately we can only have 2 injections in 24 hrs. The injections are much more expensive than the tablets. It is iniquitous that vital medicine for Cluster headaches and migraines is so expensive.

100% Oxygen at a rate of 7 - 12 Litres per minute - Might abort attack. The good thing is you can inhale often as needed. The drawback is you cannot carry it about everywhere. Also Highly Flammable!
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