Cluster Headaches Treatments
The below information is from EmedicineHealth
Abortive treatments
Inhalation of high-flow, concentrated oxygen is extremely effective in stopping a cluster headache attack and is the treatment of choice. Although oxygen is readily available in emergency departments, its widespread use in the home setting is limited by safety concerns and other reasons.
An occipital nerve steroid injection of methylprednisolone acetate (Depo-Medrol) may stop a cluster headache attack.
The following are abortive drugs in the triptan class. They are used to stop cluster headache attacks in progress, but they have little preventive value.
The following nontriptans are also used to stop attacks. They are sometimes effective when triptans fail.
People who have frequent cluster headache attacks and report that the attacks affect quality of life should use preventive therapy as the main element of their treatment plan. Specific headache-stopping drugs (abortive treatments) may also be taken as necessary.
The goals of preventive therapy include decreasing the frequency and severity of acute attacks and improving quality of life.
The choice of preventive medication should be tailored to the individual's profile, taking into account comorbidities (concurrent medical conditions) such as depression, weight gain issues, exercise tolerance, asthma, and pregnancy plans. All medications have side effects; therefore, selection must be individualized.
Preventive drugs include beta-blockers, tricyclic antidepressants, some anticonvulsants, calcium channel blockers, cyproheptadine (Periactin), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn). Unlike the specific headache-stopping drugs (abortive drugs), most of these were developed for other conditions and have been coincidentally found to have headache preventive effects. The following drugs also have preventive effects; unfortunately, they also have more side effects:
Medical Author:
Edward Lubin, MD, PhD
Medical Editor:
Joseph Carcione Jr, DO, MBA
Medical Editor:
Francisco Talavera, PharmD, PhD
Medical Editor:
James H Halsey, MD
Abortive treatments
Inhalation of high-flow, concentrated oxygen is extremely effective in stopping a cluster headache attack and is the treatment of choice. Although oxygen is readily available in emergency departments, its widespread use in the home setting is limited by safety concerns and other reasons.
An occipital nerve steroid injection of methylprednisolone acetate (Depo-Medrol) may stop a cluster headache attack.
The following are abortive drugs in the triptan class. They are used to stop cluster headache attacks in progress, but they have little preventive value.
- Sumatriptan (Imitrex)
- Naratriptan (Amerge, Naramig)
- Zolmitriptan (Zomig, Zomig-ZMT)
- Rizatriptan (Maxalt, Maxalt-MLT)
- Almotriptan (Axert)
- Frovatriptan (Frova)
- Eletriptan (Relpax)
The following nontriptans are also used to stop attacks. They are sometimes effective when triptans fail.
- Ergotamine (Cafatine, Cafergot, Cafetrate, Ercaf)
Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray) - Acetaminophen-isometheptene-dichloralphenazone (Midrin)
Intranasal lidocaine (4%) - Intranasal capsaicin
Prednisone (Deltasone) - Too toxic for long-term use but should be tried if other therapies fail
People who have frequent cluster headache attacks and report that the attacks affect quality of life should use preventive therapy as the main element of their treatment plan. Specific headache-stopping drugs (abortive treatments) may also be taken as necessary.
The goals of preventive therapy include decreasing the frequency and severity of acute attacks and improving quality of life.
The choice of preventive medication should be tailored to the individual's profile, taking into account comorbidities (concurrent medical conditions) such as depression, weight gain issues, exercise tolerance, asthma, and pregnancy plans. All medications have side effects; therefore, selection must be individualized.
Preventive drugs include beta-blockers, tricyclic antidepressants, some anticonvulsants, calcium channel blockers, cyproheptadine (Periactin), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn). Unlike the specific headache-stopping drugs (abortive drugs), most of these were developed for other conditions and have been coincidentally found to have headache preventive effects. The following drugs also have preventive effects; unfortunately, they also have more side effects:
- Methysergide (Sansert)
- Verapamil (Calan, Verelan, Covera-HS)
- Lithium carbonate (Eskalith, Lithane, Lithobid, Lithonate, Lithotabs)
- Indomethacin (Indocin): This drug can cause psychosis in some people with cluster headaches.
Medical Author:
Edward Lubin, MD, PhD
Medical Editor:
Joseph Carcione Jr, DO, MBA
Medical Editor:
Francisco Talavera, PharmD, PhD
Medical Editor:
James H Halsey, MD
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All information contained on TNNME web site is for informational purposes only and at no time should any content on TNNME be considered medical or legal advice or imply any action should be taken.. It is in no way intended to be used as a replacement for professional medical treatment. TNNME makes no claims as to the scientific/clinical validity of the information on this site OR to that of the information linked to and from this site. All information taken from the internet should be discussed with a medical professional!
All information contained on TNNME web site is for informational purposes only and at no time should any content on TNNME be considered medical or legal advice or imply any action should be taken.. It is in no way intended to be used as a replacement for professional medical treatment. TNNME makes no claims as to the scientific/clinical validity of the information on this site OR to that of the information linked to and from this site. All information taken from the internet should be discussed with a medical professional!
