Treatment for cluster headaches involves:
- Medicines to treat the pain when it happens
- Medicines to prevent the headaches
TREATING CLUSTER HEADACHES WHEN THEY OCCUR
Your doctor may recommend the following treatments for when the headaches occurs:
- Triptans, such as sumatriptan (Imitrex)
- Anti-inflammatory (steroid) medicines such as prednisone -- starting with a high dose, then slowly decreasing it over 2-3 weeks
- Breathing in 100% (pure) oxygen
- Injections of dihydroergotamine (DHE), which can stop cluster attacks within 5 minutes (Warning: this drug can be dangerous if taken with sumatriptan)
You may need more than one of these treatments to control headache symptoms. Your doctor may have you try several medications before deciding which works best for you.
Painkillers and narcotics do not usually relieve the pain from cluster headaches. Generally, they take too long to work.
PREVENTING CLUSTER HEADACHES
Avoid smoking, alcohol use, certain foods, and other factors that seem to trigger your cluster headaches. A headache diary can help you identify your headache triggers. When you get a headache, write down the day and time the pain began. The diary should include notes about:
- What you ate and drank in the last 24 hours, how much you slept and when, and what was going on in your life right before the pain started. For example, were you under any unusual stress?
- About how long the headache lasted, and what made it stop.
The headaches may go away on their own, or you may need treatment to prevent them. The following medications may also be used to treat or prevent headache symptoms:
- Blood pressure medicines, such as beta-blockers (propanolol) or calcium channel blockers such as verapamil
- Drugs used to treat seizures, such as topiramate and valproic acid
- Lithium carbonate
- Medicines used to treat depression, such as amitriptyline
In rare cases, a device that delivers tiny electrical signals to a certain nerve near the brain may be placed. This device is called a neurostimulator. However, it is not yet an established therapy for cluster headaches.