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 | Are there any prescription treatments for cluster headaches?
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|  Cluster headaches are a rare type of headache that causes severe pain on one side of the head. Other symptoms include watery eyes, runny or stuffy nose, and facial sweating. Cluster headaches usually last from 15 minutes to two hours. They are called cluster headaches because they occur frequently over a period of weeks to months, followed by a period without symptoms. Doctors don't know what causes cluster headaches, but inflammation and changes in blood flow to the brain may be involved. Some treatments relieve pain once a headache starts. Others are used to prevent headaches. Inhaled oxygen is the primary therapy for cluster headaches. It relieves them in up to 70 percent of people, and has no side effects. But oxygen supplies can be difficult to use at home or carry with you. Sumatriptan (brand name Imitrex), which is given by injection, is also a very effective treatment. It works in up to 75 percent of people, but can be used no more than twice daily. Other therapies for cluster headaches include ergotamine (Cafergot) tablets or rectal suppositories, dihydroergotamine (D.H.E., Migranal) injections or nasal spray, sumatriptan (Imitrex) tablets and nasal spray, zolmitriptan (Zomig) tablets, and naratriptan (Amerge) tablets. These therapies are generally less effective than oxygen and injectable sumatriptan. It is also possible that nasal drops of lidocain (Xylocaine) may help by numbing the pain.
Surgeries have become options to stopping the cluster headaches, but only in severe cases and by the recommendation of your doctor. Treatments aimed at preventing cluster headaches include verapamil (Calan), lithium (Lithobid), ergotamine (Ergostat), methysergide (Sansert) and prednisone (Orasone). These medicines are effective for reducing the number of cluster headaches in up to 70 percent of people. It isn't clear exactly how they work to prevent cluster headaches. They may decrease inflammation or regulate blood flow to the brain. Sources:
Walling, A.D. "Cluster Headache," American Family Physician 47 (1993).
Plosker, G.L. "Sumatriptan. A Reappraisal of its Pharmacology and Therapeutic Efficacy in the Acute Treatment of Migraine and Cluster Headache," Drugs 47 (1994).
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Silberstein, S.D., R.B. Lipton, P.J. Goadsby. Headache in Clinical Practice. Isis Medical Media, 1998.
Medline Plus. Medline, 2007.
Diseases and Conditions, "Cluster headache." http:www.mayoclinic.com. Mayo Clinic Health. Last accessed 1/3/2007.
This answer prepared 5/17/2000.
This information updated 1/3/2007.
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