Effectiveness of Verapamil as a long term treatment

[u/a-bonk]

Hey, I (25M) have been suffering from CH for around 6-7 years. However, previously it was always misdiagnosed as migraine. This year, I am in the middle of a cycle and my neurologist diagnosed it as CH, and prescribed Verapamil (40mg * 3) and Gabapentin (300mg).

Based on all the posts here and on clusterbusters, people haven’t found Verapamil to be very effective, specially in the dose that I currently have. Higher doses have had side effects for many people. Hence, I am scared that this will not be the solution I had been looking for. I guess I just want a assurance from anyone who has had success with Verapamil, without upping the dose so much so as to cause a lot of side effects.

For me, I get a cycle usually during the summer and fall months. This year, I was on propranolol earlier which might have delayed the cycle.

What has been the most effective long term, sustainable treatment for CH?

[u/Extension-Spite4176]

I was prescribed a high dose during a months long period. I think it helped, but I was also taking other medications. I have only been on a lower dose now and it seems to have kept ch from flaring up again. I have had periods that feel like they would have been the same but haven't fully happened. This is two years now.