TREATMENTS
Abortive Cluster Headache Treatment
There is very little help for the cluster patient other than medication and oxygen. Cluster patients are not able to hold still for relaxation or massage therapies as they often feel better when they pace or move about. Cluster headache onset is very fast and the attacks are brief (about 30-45 minutes on average) consequently treatments most be fast acting and readily available.
Typical Abortive Medication Classes
Inhaling 100 percent oxygen through a mask at a minimum rate of 10-12 liters a minute for 10-20 minutes provides dramatic relief for more than 60% of patients that try it. It is safe and inexpensive procedure without side effects and can even be combined with other treatments. Of course the major drawback of oxygen is the need to carry an oxygen cylinder with you. Do not to smoke or be near an open flame if you're using oxygen as it can explode.
The injectable form of sumatriptan (Imitrex –see the abortive section in migraine treatment) is an effective acute treatment for cluster headache. Some people prefer sumatriptan in nasal spray form if it is as effective for them as the shot. It is much easier to use when out at work for instance, but for most people sprays are not as effective as an injection. Another triptan, Zomig (zolmitriptan), can be taken by nasal spray as well for relief of cluster headache. This medication is not as strong or as quick acting but may be an option if you can't tolerate the other forms of fast-acting treatments. Triptans are not recommended if you have uncontrolled high blood pressure or ischemic heart disease or risk of ischemic stroke.
This medication is available in intravenous, injectable and inhaled forms. Dihydroergotamine (D.H.E. 45 injection, Migranal nasal spray) is an effective pain reliever for some people with cluster headache. When administered intravenously, you'll need to go to a hospital or doctor's office to have an intravenous (IV) line placed in a vein but you can be taught how to do injections at home. The nasal spray often works too slowly to be effective.
Sandostatin (octreotide Acetate) is an injectable synthetic version of the brain hormone somatostatin, it may be as effective for cluster headache as the ergotamines (DHE) but it is safe if you have high blood pressure and ischemic heart disease and cannot use triptans.
Lidocaine (Xylocaine), may be effective against cluster headache by the numbing the pain when applied intranasally; however, it does not help abort the attack.
Oxygen
Triptans
Dihydroergotamine
Sandostatin
Local Anesthetics