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Medicines for Cluster Headaches

Topic Overview

Medicines may stop a cluster headache after it starts and prevent more headaches from occurring. Finding the right medicine can take some time. You may need a combination of medicines to effectively treat your cluster headaches.

Medicines and treatments that stop cluster headaches after they start

Treatments most often used to stop cluster headaches include:

  • High-flow oxygen inhalation therapy, in which you breathe oxygen through a face mask to relieve headache pain. Oxygen therapy is one of the best treatments to stop a cluster headache. Oxygen therapy relieves headache pain within 15 minutes in more than 7 out of 10 people who use it. It works best when started right when a cluster headache starts.1 But you need to repeat the treatment when the next headache begins.
  • Triptans, which can be given as a shot, sprayed in the nose, or taken by mouth as a pill to reduce pressure and pain.
  • Octreotide, which can be used as a shot to stop headache pain.
  • Lidocaine, which is taken by nose drops to stop severe headache pain.
  • Ergotamine preparations, which can be given as a pill or in a vein to relieve pressure and reduce headache pain.

Medicines that prevent cluster headaches during a cluster period

Medicines that prevent cluster headaches during a cluster period include:

  • Corticosteroids, such as prednisone. These medicines are used to stop cluster headaches for a short time. These medicines give you some relief from headaches while preventive medicines start to work. Corticosteroids are not used as preventive medicines long-term because of bad side effects.
  • Verapamil. This medicine is used to prevent or reduce the number of headaches in a cluster cycle. Verapamil is commonly used for preventing both occasional and chronic cluster headaches.
  • Lithium. This medicine is often prescribed to prevent chronic cluster headaches.
  • Antiseizure medicines, such as valproate. These may be tried if other treatments are not effective.
  • Ergotamine. This medicine can be used at bedtime to prevent cluster headaches overnight.

You must take these medicines every day during a cycle of headaches, even on days when you don't get a headache.

What to think about

Over-the-counter pain medicines, such as aspirin, acetaminophen, and ibuprofen, usually don't relieve the severe pain of cluster headaches. Also, prescription narcotic pain medicines are not recommended for cluster headaches.

When a cluster headache occurs, it is important to treat it as early as possible with the medicine your doctor has recommended. The sooner you treat the headache, the less painful it may be.

The choice of medicine may depend on the time of day when your headaches tend to occur. Some people may need a combination of two or three medicines. Keeping track of your symptoms can help your doctor determine the proper medicine. You can keep track by using a headache diaryheadache diary(What is a PDF document?).

If you don't get headaches often, you may only need to take medicines after the headaches begin. If you get headaches often, you may need to take medicines daily during a cluster period to prevent a future headache or reduce the number of headaches in a cycle.

If your headaches become more severe and medicines aren't working, let your doctor know. You may need to try a different medicine or a combination of medicines. You may also need to be referred to a hospital or headache clinic for more intensive treatment.

Other Places To Get Help

Organizations

American Headache Society Committee for Headache Education (ACHE)
19 Mantua Road
Mount Royal, NJ  08061
Phone: (856) 423-0043
Fax: (856) 423-0082
Email: achehq@talley.com
Web Address: www.achenet.org
 

The American Headache Society Committee for Headache Education (ACHE) is a nonprofit partnership between health professionals and headache sufferers. ACHE provides resources and tools to health care professionals to help them help their headache patients. This website has many educational resources for doctors, patients, families, schools, and employers. Resources include newsletters, articles on headaches, tools for both patients and doctors, and lists of certified headache doctors.


National Headache Foundation (NHF)
820 North Orleans
Suite 217
Chicago, IL  60610
Phone: 1-888-NHF-5552 (1-888-643-5552)
Phone: (312) 274-2650
Email: info@headaches.org
Web Address: www.headaches.org
 

The National Headache Foundation is a nonprofit organization dedicated to three major goals: educating the public that headaches are serious disorders and that sufferers need understanding and continuity of care; promoting research into potential headache causes and treatments; and serving as an information resource for sufferers, their families, and doctors who treat them. The NHF can provide lists of local doctors specializing in headache treatment. It also has a monthly newsletter and many pamphlets on a variety of topics related to the different headache syndromes.


Related Information

References

Citations

  1. Cohen AS, et al. (2009). High-flow oxygen for treatment of cluster headache: A randomized trial. JAMA, 302(22): 2451–2457.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Colin Chalk, MD, CM, FRCPC - Neurology
Last Revised January 27, 2012

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