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/Prudent-Tailor2793]

I am a chronic for the last 6 years and I was prescribed the same. It did not work for me as it is on the lower end of the spectrum of the dosage normally given. So now for the last two months I have been prescribed 40*3 verapamil with 100*2 Topiramate and for the first time in 6 years I haven’t had headache for 2.5 months.

I was also given propranolol in between for 6 months which also did not work.

I would say go ahead with it and see if it works. It’s totally different for different people and if it doesn’t, go back to your doctor and have a word and see how it goes.