Cluster headache treatment

The following drugs are used in migraine and cluster headache treatment ... 

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. 

Dihydroergotamine For the acute treatment of migraine headaches with or without aura and the acute treatment of cluster headache episodes (injection only). Dihydroergotamine nasal spray is not intended for the prophylactic therapy of migraine or for the management of hemiplegic or basilar migraine. 

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. 

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... 

How does treatment of migraine headaches differ from treatment of tension and cluster headaches ... 

The International Headache Society classifies headaches into one of 13 categories, ranging from migraine, tension-type, and cluster headaches, to headaches that are not classifiable. Effective headache treatment is thus guided by an accurate diagnosis of the headache type. 

BA is a 37-year-old man with newly diagnosed cluster headaches. The headaches have been lasting 1 to 2 hours per attack, and come on suddenly. He has no other comorbid conditions, and lives a very active lifestyle. Which treatment would be most appropriate for abortive treatment of his headache syndrome ... 

Dechant, K.L. etal. (1992) Sumatriptan. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the acute treatment of migraine and cluster headache. Drugs. 43, 776-798. 

The standard acute treatment of cluster headache is inhalation of 100% oxygenby facial mask at a rate of 7-10 L/min for 10 to 15 minutes." Repeat administration may be necessary because of recurrence because oxygen appears merely to delay, rather than abort, the attack in some patients. No side effects have been reported with the use of oxygen. 

Subcutaneous and intranasal sumatriptan is considered safe and effective treatment for acute cluster headaches." Adverse events reported in cluster headache patients are similar to those seen in migraineurs. Sumatriptan has been used in the management of cluster headaches for up to 1 year without evidence of tachyphylaxis or increased toxicity. Orally administered sumatriptan has limited use in cluster attacks because of its relatively long onset of action oral zohnitriptan, however, was efficacious in patients with episodic cluster headache, with 60% of patients experiencing relief (mild or no pain) at 30 minutes." ... 

Initial side effects are mild and include tremor, lethargy, nausea, diarrhea, and abdominal discomfort. Lithium treatment has been associated with headache symptoms described as episodes of moderately severe, throbbing occipital pain lasting 6 to 12 hours, but these headaches are easily distinguishable from the cluster headache and disappear when lithium is withdrawn. Lithium should be administered with caution to patients with significant renal or cardiovascular disease, dehydration, pregnancy, or concomitant diuretic use. 

In patients unresponsive to other therapies, methysergide 4 to 8 mg/ day in divided doses is usually effective in shortening the course of cluster headaches. Response to treatment usually occurs within 1 week of initiation of the drug. Response rates in patients with episodic cluster headache approach 70%, but chronic cluster headache patients receive less benefit. Precautions regarding methysergide use were described earlier in this chapter. 

Bahra A, Gawel MJ, Hardebo JE, et al. Oral zolmitriptan is effective in the acute treatment of cluster headache. Neurology 2000 54 291-296. 

Local and spinal anesthetic also used for treatment of status epilepticus migraine and cluster headaches ventricular arrhythmias, ventricular fibrillation cardiac arrest neuropathic pain, postherpetic neuralgia... 

During the past three decades, it has been possible to extend the classical antimanic, antidepressive and recurrent-prophylactic action profile of lithium by an antipsychotic (Alexander et al. 1979), antiaggressive (Nilsson 1994), antisuicidal (Mtiller-Oerlinghau-sen et al. 1992), antineurotic (PfafFenrath et al. 1982) and neuroprotective (Ermidou-Pollet and Pollet 2002) component. Though lithium is even the first-choice treatment in the prophylaxis of chronic and episodic courses of cluster headache in patients, who are aged over 45 years (Pfaf-fenrath et al. 1982), all the results with the antineurotic properties of lithium are based on open trials. Clear evidence of the antineurotic effect of lithium has not yet... 

HTjj, agonists Sumatriptan, a substituted indole compound, is the prototype. Nara-triptan and rizatriptan are similar. They are effective in the treatment of acute migraine and cluster headache attacks, an observation that strengthens the association of serotonin abnormalities with these headache syndromes. These drugs are active orally sumatriptan is also available for parenteral administration. 

Franzini, A. et al., Stimulation of the posterior hypothalamus for treatment of chronic intractable cluster headaches first reported series. Neurosurgery, 2003, 52 1095-1099 discussion 1099-1101. 

Husid MS (2007) Cluster headache a case-based review of diagnostic and treatment approaches. CurrPain Headache Rep 10(2) 117-125. doi 10.1007/sl 1916-006-0022-2... 

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