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Individualizing Treatment with Verapamil
Background: Verapamil is currently the
best available prophylactic drug for patients experiencing cluster
headaches (CH). Published papers usually state 240 to 480 mg.
taken in three divided doses give good results, ranging from 50%
to 80%; others mention higher doses -- 720, even 1200 mg. per day.
In clinical practice we found we needed to adapt dosage to
individualís time of attacks, in particular giving higher doses
before going to bed to suppress severe nocturnal episodes. A few
only required 120 mg. daily. We therefore evolved a scheme for
steady and progressive drug increase until satisfactory control
had been achieved.
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