ask your pharmacist

Are there any prescription treatments for cluster 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.

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.

This answer prepared 5/17/00.