Cluster Headache Treatment
Nasal lidocaine, as either a spray or drops, can be used for the treatment of cluster headaches. Patients should apply the nasal lidocaine on the affected side at the first sign of a cluster headache. A second application can be applied after 15 minutes. No more than two treatments should be used per headache and no more than four treatments per day.
In several studies, olanzapine has been shown to be effective in stopping cluster headaches within 20 minutes.
Preventive MedicationsPrevention of cluster headaches is an integral part of any treatment plan. The exact medication recommended for you will depend on other medical conditions you may have and previous medicines that you have tried.
Preventive medications for cluster headache are generally used for either a short-term, transitional strategy or a long-term, maintenance strategy. The short-term medications work quickly but may have undesirable side effects. They include:
- Corticosteroids, such as prednisone or dexamethasone (Decadron®)
- Ergotamine (Bellamine-S®, Cafergot®, Ergomar®).
Long-term medications take effect more slowly but can be used safely throughout the cluster period. They include:
- Propranolol (Inderal®)
- Divalproex (Depakote®)
- Topiramate (Topamax®)
- Verapamil (Calan®, Verelan®)
- Methysergide (Sansert®)
- Lithium (Eskalith®, Lithobid®)
If your healthcare provider has prescribed medications for you to help prevent cluster headaches, take them exactly as prescribed. Ask what you should do if you miss a dose.
To avoid long-term side effects of preventive medications, headache specialists advise patients to reduce the dosage of these drugs and then stop taking them as soon as possible (usually after 14 days of being headache-free). Make sure you have talked with your healthcare provider about how to safely stop these medicines. Also, talk with your healthcare provider if the amount of medicine you are prescribed is not helping your headaches.