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Cluster headache: symptomatic treatment.

P Torelli1, G C Manzoni

  • 1Headache Centre, Section of Neurology, Department of Neuroscience, University of Parma, Via Gramsci 14, I-43100 Parma, Italy. paolatorelli@libero.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|November 19, 2004
PubMed
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Subcutaneous sumatriptan and 100% oxygen are first-choice treatments for cluster headache (CH) attacks. Oxygen offers a side-effect-free alternative, while sumatriptan is effective for prolonged use in managing CH symptoms.

Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Cluster headache (CH) demands rapid symptomatic relief.
  • Effective acute treatments are crucial for managing debilitating CH attacks.

Purpose of the Study:

  • To review and compare the efficacy and safety of acute treatments for cluster headache (CH).
  • To identify first-line and alternative therapeutic options for CH symptom management.

Main Methods:

  • Literature review of clinical management strategies for CH.
  • Analysis of pharmacological (sumatriptan, zolmitriptan, ergotamine) and non-pharmacological (oxygen inhalation) treatments.
  • Evaluation of treatment efficacy, safety profiles, and practical considerations.

Main Results:

  • Subcutaneous sumatriptan (6 mg) and 100% oxygen inhalation (7 L/min for ≤15 min) are primary treatments for CH.

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  • Oxygen therapy is side-effect-free and has broader contraindications than sumatriptan.
  • Sumatriptan is safe for long-term use with mild side-effects; nasal formulations are less effective.
  • Other options include hyperbaric oxygen and intranasal cocaine/lidocaine.

    • Conclusions:

    • Subcutaneous sumatriptan and oxygen inhalation are effective first-line treatments for acute cluster headache.
    • Oxygen therapy presents a safe, side-effect-free alternative, suitable for patients with comorbidities.
    • While sumatriptan is a reliable option, its use requires consideration of contraindications, unlike oxygen therapy.