Treatment of Cluster Headache

Cluster headache treatment involves the following two types-

Abortive Medications or Therapy to relieve the pain when it happens
Preventive Medications or Therapy to prevent the cluster headaches

Abortive Medication

Abortive Medication regime usually involves treating with Triptans, mainly sumatriptan (Imigran / Imitrex) or Injections of dihydroergotamine (DHE), or oxygen breathing therapy with 100% pure oxygen.

Sumatriptan is an injection that is given within 10 minutes of the onset of the cluster episode. Sumatriptan works in a similar way as that of the brain chemical 5HT. It causes the blood vessels to narrow and thus reducing blood-flow to the brain.

Injections of dihydroergotamine (DHE), when administered, can stop the cluster attack within 5 minutes. However, DHE must not be administered with Sumatriptan or other triptans, as it is dangerous.

The oxygen therapy involves breathing of a high flow of pure oxygen through a mask for about 15 minutes – 20 minutes, up to five times a day. It is a safe treatment and has proven to be effective in relieving cluster headaches.

Preventive Treatment

Most of the cluster headaches might go away on their own. However, preventive medications are recommended in recurrent or chronic cases of Cluster Headaches.

Calcium channel blocker Verapamil tablets, usually used in cardiac diseases are helpful in treating cluster headaches. However, frequent ECG monitoring is essential whilst adjusting or increasing the dose of Verapamil.
Blood pressure medicines, mainly beta-blockers like propanolol or atenolol.

Drugs used to treat mood disorders like Lithium carbonates.
Cyproheptadine
Drugs used to treat seizures, such as topiramate and valproic acid
Medicines used to treat depression and anxiety such as amitriptyline.

Published on Feb 24, 2014

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Cluster headache - (http://www.nlm.nih.gov/medlineplus/ency/article/000786.htm)
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