Cluster headaches

Cluster Headache and Other Trigeminal Autonomic Cephalalgias... 

Cluster headache disorders are the most uncommon and severe primary headache syndromes.9 The estimated point prevalence is less than 1%. Unlike migraine and TTH, cluster headaches occur more frequently in men. Onset commonly occurs prior to age 30.6 A genetic predisposition seems apparent, although affected individuals often provide a history of tobacco use and alcohol abuse.6 Attacks consist of debilitating, unilateral head pains that occur in series lasting up to months at a time, but that remit over months to years between occurrences. In rare instances, cluster headache can be a chronic disorder without remissions.4... 

Pain associated with cluster headache differs from migraine and TTH in that it is severe, intermittent, and short in duration.6 Headaches typically occur at night, but attacks may occur multiple times per day.9 The pain is usually unilateral, but unlike migraine it is not described as pulsatile.6 Aura is not a feature,... 

Patients experiencing cluster headache may display the following headache symptoms and characteristics ... 

Cluster headache responds to many of the same treatment modalities used in acute migraine however, initial prophylactic therapy is required to limit the frequency of recurrent headaches within a periodic series. A novel therapy specific to cluster headaches is the administration of high-flow-rate oxygen 100% at 5 to 10 L/minute by non-rebreather facemask for approximately 15 minutes.42 If pain is not aborted, then retreatment is indicated. No side effects are seen with short-term oxygen use. If oxygen therapy is not wholly effective, then pharmaceuticals... 

Cluster headache (sumatriptan injection only) Acute treatment of cluster headache episodes. 

Not intended for the prophylactic therapy of migraine or for use in the management of hemiplegic or basilar migraine. Safety and efficacy have not been established for cluster headache, which is present in an older, predominantly male population (almotriptan, eletriptan, frovatriptan, sumatriptan tablets and spray, zolmitriptan). 

Headache To abort or prevent vascular headaches such as migraine, migraine variant, and cluster headache (histaminic cephalalgia). 

Gregor N, Schlesiger C, Akova-OztUrk E, Kraemer C, Husstedt I-W, Evers S. Treatment of cluster headache attacks with less than 6 mg subcutaneous sumatriptan. Headache 2005 45 1069-72. 

Wilkinson M, Pfaffenrath V, Schoenen J, Diener HC, Steiner TJ. Migraine and cluster headache their management with sumatriptan a critical review of the current clinical experience. Cephalalgia 1995 15 337-57. 

Migraine headaches, cluster headaches IM, Subcutaneous 1 mg at onset of headache repeat hourly. Maximum 3 mg/day 6 mg/wk. IV 1 mg at onset of headache repeat hourly Maximum 2 mg/day 6 mg/wk. Intranasal 1 spray (0.5 mg) into each nostril repeat in 15 min. Maximum 4 sprays/day 8 sprays/wk. 

Unlabeled Uses Treatment of chronic and classic migraine, chronic cluster headaches... 

Merck and Co., Inc., have patented imidazo[4,5-3]pyridines of the general structure 194, which have been found to be antagonists of calcitonin gene-related peptide (CGRP) receptors, which are useful for the treatment of the symptoms for headache, migraine, and cluster headaches <2005W0013894>. Merck have also patented the... 

It is indicated in acute hypomania, mania, recurrent mania, depression - cyclic and recurring, unipolar depression, bipolar depression, schizoaffective psychosis, mental depression, cluster headache, chemotherapy induced leukopenia and agranulocytosis. 

Sumatriptan Partial agonist at 5-HT1B/1D receptors Effects not fully understood may reduce release of calcitoningene-related peptide and perivascular edema in cerebral circulation Migraine and cluster headache Oral, nasal, parenteral duration 2 h Toxicity Paresthesias, dizziness, coronary vasoconstriction Interactions Additive with other vasoconstrictors... 

Ergotamine Mixed partial agonist effects at 5-HT2 and (X adrenoceptors Causes marked smooth muscle contraction but blocks cx-agonist vasoconstriction Migraine and cluster headache Oral, parenteral duration 12-24 h Toxicity Prolonged vasospasm causing gangrene uterine spasm... 

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