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Treating cluster headaches
Cluster headache sufferers generally must take preventive medication when they enter a cluster period unless the cluster periods last less than two weeks. Some medications used in the prevention of these headaches include calcium channel blockers, verapamil, lithium carbonate, divalproex sodium, corticosteroids, methysergide, melatonin, and topiramate.
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Because of the brief duration of an attack, treatment to abort these headaches is difficult. Oxygen inhalation by facial mask can be used at the first signs of a cluster attack and has been used successfully in aborting an acute cluster headache. Sumatriptan (Imitrex) injections are often prescribed for the acute treatment of cluster headaches. Other choices include zolmitriptan tablets and ergotamine preparations. Some patients have gained some relief with the use of intranasal applications of a local anesthetic agent, such as lidocaine. But often the acute headache has disappeared before the patient arrives at the emergency department or physician's office to receive treatment.
Surgical intervention may be considered for people with chronic cluster headaches who have not been helped with standard therapy.
All of these treatments should be used under the direction of a physician familiar with cluster headache therapy.
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