How are cluster headaches treated?
Cluster headaches may be very difficult to treat, and it may take trial and error to find the specific treatment regimen that will work for each patient. Since the headache recurs daily, there are two treatment needs. The pain of the first episode needs to be controlled, and the headaches that follow need to be prevented.
Initial treatment options may include one or more of the following:
- inhalation of high concentrations of oxygen (though this will not work if the headache is well established);
- injection of triptan medications, like, sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt) which are common migraine medications;
- Spraying or dripping lidocaine, a local anesthetic, into the nostril;
- dihydroergotamine (DHE, Migranal), a medication that causes blood vessels to constrict; and
Prevention of the next cluster headache may include
- calcium channel blockers, for example, verapamil (Calan, Verelan, Verelan PM, Isoptin, Covera-HS) and diltiazem (Cardizem, Dilacor, Tiazac);
- prednisone (Deltasone, Liquid Pred);
- antidepressant medications;
- lithium (Eskalith, Lithobid); and
- antiseizure medications including valproic acid, divalproex (Depakote, Depakote ER, Depakene, Depacon), and topiramate (Topamax).