Hello! Welcome and thank you for asking on HCM! Yours seems to be a complicated and resistant case of Cluster Headache (CH), based on the therapy you have used before. I would recommend trying corticosteroids. They are extremely effective in terminating a CH cycle and in preventing immediate headache recurrence. High-dose prednisone is prescribed for the first few days, followed by a gradual taper. Simultaneous use of standard prophylactic agents (eg, verapamil) is recommended. Another option is intervention therapy: -Greater occipital nerve block may be beneficial in aborting CH -Deep brain stimulation with implantation of stimulating electrodes under stereotactic guidance into the ipsilateral posterior inferior hypothalamus is another potential option for chronic CH refractory to pharmacologic therapy. -Stimulation of the sphenopalatine ganglion, which is located in the pterygopalatine fossa, may also be considered. I would also recommend avoiding the known headache triggers to the extent possible. For example, disturbances in the sleep cycle can induce attacks. Strong emotions and excessive physical activity may also induce attacks. Tobacco may slow responsiveness to medications. Narcotics may expedite transformation of episodic CH to chronic CH. I recommend discussing with your attending physician on the above mentioned issues. Hope to have been helpful! Best wishes, Dr. Aida