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Review
. 2022 Jan;82(1):33-42.
doi: 10.1007/s40265-021-01658-z. Epub 2021 Dec 17.

Drug Treatment of Cluster Headache

Hans Christoph Diener  1 , Arne May  2
Affiliations
Review

Drug Treatment of Cluster Headache

Hans Christoph Diener et al. Drugs. 2022 Jan.

Abstract

Cluster headache belongs to the group of trigeminal autonomic headaches. This review summarizes drug therapy of cluster attacks and prophylactic treatment. Neurostimulation methods are not addressed. The therapy for acute cluster attacks includes inhalation of 100% oxygen, subcutaneous administration of sumatriptan, and intranasal application of sumatriptan or zolmitriptan. Bridging therapy, which is used until oral prophylactic therapy is effective, is performed either with oral prednisolone or with a pharmacological block of the major occipital nerves. Best documented drugs for preventive treatment of cluster headache are verapamil and lithium, and possibly effective drugs are gabapentin, topiramate, divalproex sodium, and melatonin. The efficacy of monoclonal antibodies to the calcitonin gene-related peptide so far has been only demonstrated for episodic cluster headache. Several drug therapies are being investigated including ketamine, onabotulinumtoxinA, lysergic acid, and sodium oxybate.

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Conflict of interest statement

HCD received honoraria for participation in clinical trials, contribution to advisory boards, or oral presentations from: Ipsen, Lilly, Lundbeck, Novartis, Pfizer, and Teva. The German Research Council (DFG), the German Ministry of Education and Research (BMBF), and the European Union support his headache research. HCD serves on the editorial boards of Cephalalgia, Drugs, and Lancet Neurology. HCD is a member of the Clinical Trials Committee of the IHS. AM is the editor of Cephalalgia and reports no conflicts of interest.

References

    1. Headache Classification Committee of the International Headache Society (IHS) The international classification of headache disorders ICHD-3, 3rd edition. Cephalalgia. 2018;38(1):1–211. - PubMed
    1. Fischera M, Marziniak M, Gralow I, Evers S. The incidence and prevalence of cluster headache: a meta-analysis of population-based studies. Cephalalgia. 2008;28(6):614–618. - PubMed
    1. Cohen AS, Mathura MS, Burns B, Goadsby PJ. Randomized, double-blind placebo-controlled trial of high-flow inhaled oxygen in acute cluster headache. Cephalalgia. 2007;27:1188.
    1. Petersen AS, Barloese MC, Lund NL, Jensen RH. Oxygen therapy for cluster headache. A mask comparison trial. A single-blinded, placebo-controlled, crossover study. Cephalalgia. 2017;37(3):214–224. - PubMed
    1. The Sumatriptan Cluster Headache Study Group Treatment of acute cluster headache with sumatriptan. N Engl J Med. 1991;325:322–326. - PubMed

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