Antiandrogenic medication of cluster headache

The effectiveness of cyproterone acetate, a synthetic steroid with antiandrogenic action, was tested in 40 (young, adult) males, suffering from episodic (29) and chronic (11) cluster headache. Previously a minority (15) cases had been unsuccessfully treated with lithium, the conventional therapy of this condition. The rationale for an antiandrogenic treatment in cluster headache was based on its well-known clinical characteristics: 1) about 90% male sex preference; 2) rarity of clinical manifestations in childhood and in old age as well as women, e.g. in subjects with low androgenic secretion if compared to young adult males; 3) altered levels (increased or reduced, according to different authors) of plasma testosterone. The parameters to evaluate the effects of treatment were those conventional ones: intensity, duration and frequency of attacks. Antiandrogenic treatment improved, with few exceptions, by a slight, moderate or large extent, the course of cluster headache in all patients. The efficaciousness was mainly evident in those cases (15) of episodic or chronic cluster headache, previously resistant to lithium.