Episodic CH Sufferers Only
13) How often do your episodes/cycles occur (select closest)
- - - - - - - - - - - - - - - - - - - - -
Monthly
Quarterly
Bi-annually
Annually
Less than once per year
14) How long does your episode/cycle typically last (select closest)
- - - - - - - - - - - - - - - - - - - - -
Less than 1 week
1 week - 1 month
1-3 months
3-6 months
6-9 months
Most of the year
15) How many attacks do you experience each day during the peak of an episode/cycle?
- - - - - - - - - - - - - - - - - - - - -
Less than 3
3-6
6-12
More than 12
16) What is the approximate length of each attack during the peak of an episode/cycle?
- - - - - - - - - - - - - - - - - - - - -
Less than 15 minutes
15-30 minutes
30 minutes - 1 hour
1-3 hours
more than 3 hours
16) How many attacks do you experience each day during rest of the episode/cycle (on average)?
- - - - - - - - - - - - - - - - - - - - -
Less than 3
3-6
6-12
more than 12
17) What is the approximate length of each attack during rest of the episode/cycle?
- - - - - - - - - - - - - - - - - - - - -
Less than 15 minutes
15-30 minutes
30 minutes - 1 hour
1 - 3 hours
more than 3 hours
18) How far into your episode/cycle have you typically taken hallucinogenic treatment?
- - - - - - - - - - - - - - - - - - - - -
Before it starts
At the onset
At the peak
After the peak
At the end
19) Have you found that hallucinogenic treatment works best if taken
- - - - - - - - - - - - - - - - - - - - -
Prior to an episode
At the Beginning of an episode
At the Peak of an episode
After the Peak of an episode
Towards the End of an episode
Makes no difference
Don't know
NON EPISODIC CH SUFFERERS
20) How frequently do your headaches occur
- - - - - - - - - - - - - - - - - - - - -
Daily
Weekly
Monthly
Quarterly
Bi-annually
Annually
Less than once per year
21) What is the approximate length of each attack?
- - - - - - - - - - - - - - - - - - - - -
Less than 15 minutes
15-30 minutes
30 minutes - 1 hour
1-3 hours
3-6 hours
6-12 hours
12-24 hours
1-3 days
All Headache Sufferers
22) Have you ever used a hallucinogen as a treatment for your headaches?
Yes
No
If No, go to question 43
If You Have Tried Hallucinogens
23) Had you ever used a hallucinogen prior to trying them as headache treatment?
Yes
No
24) Have you used a hallucinogen non-medically since you first tried them as headache treatment?
Yes
No
25) Which hallucinogen(s) have you taken to treat your vascular headaches?
26) For the most effective hallucinogen you've tried, what effect did it have on the following factors?
27) What dose do you normally take to get optimum effectiveness?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Very Low Dose / No Effects
Low Dose / Light Effects
Medium Dose / Medium Effects
High Dose / Heavy Effects
Don't Know
28) What duration of improvement have you gotten from hallucinogens?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Less than 24 hours
Several days
Several weeks
Several months
More than 12 months
It's been years and they haven't come back
None
Don't Know
29) Was the improved period...
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Consistent improvement until the syndrome returns
Best to begin with but degenerates over time
Improves over time until the syndrome returns
Improved first, then degenerated
Up and down all over the place
None
Don't Know
30) How many treatments did it take to produce an improved period?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1
2
3
More than 3
It's an ongoing process where I must take frequent doses
31) If you have any comments about how hallucinogens improved or worsened your headaches, enter them below.
32) Were you taking any of the medications listed below immediately prior to or during the hallucinogenic treatment? (select all that are appropriate by holding down the Ctrl-key while clicking)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ergotamine, Dihydroergotamine (Cafergot)
Methysergide (Sansert)
Triptans (Imitrex, Zomg, etc)
Verapamil
Lithium
Predisone
Analgesics
Narcotics
MAO inhibitors
Beta blockers (Propanolol)
Calcium channel blockers
Steroids
Amitryptylene
Other (specify)
Other :
33) Did you follow Flash & Pinky's dosing guidelines (taking the treatment once every 5 days until an improved period was achieved, and trying each hallucinogen 3 times before switching to another if it hasn't worked)?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Followed Strictly
More or Less
No
Don't Know
34) How would you compare the most effective hallucinogen you tried with the most effective other medication you've tried?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Hallucinogen much more effective
Hallucinogen somewhat more effective
About the same
Hallucinogen not as effective
Hallucinogen much worse
Works well in combination with other medications
Don't Know
35) Has the hallucinogen of your choice ever stopped working?
Yes
No
No Answer
Used succesfully for years and months
Used number of times during that period
Used unsuccesfully for years and months
Used number of times during that period
36) Are you willing to accept "tripping" as a side-effect of reducing your headaches.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Yes, tripping is better than headaches
Only in some contexts
I don't trip at the doses I take
No
Don't Know
37) Have you ever had a bad trip or difficult psychological experience while on a hallucinogen?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Yes, extremely negative
Yes, somewhat negative
Yes, mild
No
Don't Know
38) Have you ever had a positive or mystical experience while on a hallucinogen?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Yes, extremely positive
Yes, mystical
Sometimes I enjoy them
No
Don't Know
39) How would you compare the side effects to those of other headache medications you've used?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Hallucinogen side effects much worse
Hallucinoagen side effects slightly worse
About the same level of side effects
Hallucinogen side effects somewhat less
Hallucinogen side effects much less
Don't Know
40) How do you normally feel the day after taking hallucinogens?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Feel better than normal
Feel pretty good
About normal
Feel tired or hungover
Feel bad, depressed or unwell
It varies from time to time
Dead / In a persistent vegetative state
Don't Know
41) If they were legal, would you recommend the use of hallucinogens to treat vascular headaches?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Yes, definitely
Yes, it's worth trying
It depends on the person
No, Probably not
No, Definitely not
Don't Know
Mushrooms
42) What type(s) have you used? [multiple cntrl-click]
- - - - - - - - - - - - - - - - - - - - -
Psilocybe cubensis
Psilocybe cyanescens (wavy caps)
Psilocybe semilanceata (liberty caps)
Psilocybe azurescens
Other
Don't Know
Only For Those Who Have Not Tried Hallucinogen Treatment
43) Which of the following medications have you tried to treat your headaches? (select all that are appropriate by holding down the Ctrl-key while clicking)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ergotamine, Dihydroergotamine (Cafergot)
Methysergide (Sansert)
Triptans (Imitrex, Zomg, etc)
Verapamil
Lithium
Predisone
Analgesics
Narcotics
MAO inhibitors
Beta blockers (Propanolol)
Calcium channel blockers
Steroids
Amitryptylene
Other (specify)
Other :
44) How would you describe the side effects for the medications you've tried?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Very Unpleasant
Somewhat Bothersome
Tolerable
Very Minor
No Unwanted Side Effects
Don't Know
45) If they were legal or recommended by your doctor, would you consider the use of hallucinogens to treat vascular headaches?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Yes, definitely
Yes, it's worth trying
I'd Consider It
No, Probably not
No, Definitely not
Don't Know
All Respondents
42) Please provide any other relevant comments in the box provided: