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The Best Medicine for Treating Cluster Headaches

There's not a lot we know about cluster headaches except that they strike men more often than they do women. According to Cluster Headaches Australia, women who suffer from cluster headaches and have given birth vaginally reported that giving birth was less painful than a cluster-headache attack. Treatment is multifaceted and focused on easing pain. Timing is crucial, so treatment must be given as soon as possible.

  1. Oxygen Therapy

    • Cluster-headache attacks start about an hour or two after falling asleep. One theory is that a lack of oxygen and a rise in carbon dioxide levels from obstructive sleep apnea may contribute to a cluster headache attack. (See References). One of the most promising pain relievers for cluster-headache victims is normobaric oxygen therapy, which is breathing pure oxygen from an oxygen tank. Another type of oxygen therapy is hyperbaric oxygen therapy, where the patient has to go to the hospital and breathe pure oxygen pumped into a pressurized chamber.

    Medications

    • Medications usually need to be administered by an injection or a nasal spray because the patient will not be able to keep a pill down. These medications include the triptans given to migraine patients, including sumatriptan and zolmitriptan. Other medications include lodacaine given as a nasal spray, dihydroergomatine and a synthetic version of the hormone somatostasin. These medications usually work in less than a half hour. Sometimes a local anesthetic is given in order to numb the pain, but they tend to work slower than other medications. Only in extreme circumstances are opiates such as topical intranasal cocaine given.

    Preventive Medications

    • These are medications taken every day in the hope that it will prevent a cluster-headache attack. Usually one type is prescribed but sometimes two medicines are given. These medications are prescribed as an off-label use. There are no medications available specifically for preventing cluster headaches. The most common medications are those for lowering blood pressure, including calcium channel blockers such as verapamil and beta blockers such as proplanolol. Other medications are SSRI antidepressants and antiseizure medications such as topiramate or divalproex. Lithium is also used, but any patient taking that needs constant blood tests. None of these medications are approved for pain relief.

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