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. 2024 Mar 31;14(4):348.
doi: 10.3390/brainsci14040348.

Use of Prescribed and Non-Prescribed Treatments for Cluster Headache in a Swedish Cohort

Gabriella Smedfors  1 , Felicia Jennysdotter Olofsgård  1 , Anna Steinberg  2   3 , Elisabet Waldenlind  2   3 , Caroline Ran  1 , Andrea Carmine Belin  1
Affiliations

Use of Prescribed and Non-Prescribed Treatments for Cluster Headache in a Swedish Cohort

Gabriella Smedfors et al. Brain Sci. .

Abstract

Background: Cluster headache (CH) is a debilitating condition, but current therapies leave CH patients in pain. The extent of this problem in Sweden is unknown.

Methods: An anonymized questionnaire was sent to 479 Swedish CH patients to investigate patterns and perceived effects of treatments.

Results: Three hundred fourteen answers were analyzed. The population was representative regarding age of onset and sex. Less than half (46%) were satisfied with their abortive treatments, 19% terminated functioning abortive treatments due to side effects. Additionally, 17% of chronic CH patients had not tried the first-line preventive drug verapamil. A small subset had tried illicit substances to treat their CH (0-8% depending on substance). Notably, psilocybin was reported effective as an abortive treatment by 100% (n = 8), and with some level of effect as a preventive treatment by 92% (n = 12). For verapamil, some level of preventive effect was reported among 68% (n = 85).

Conclusions: Our descriptive data illustrate that many Swedish CH patients are undertreated, lack functional therapies, and experience side effects. Further studies are warranted to search for new treatment strategies as well as a revision of current treatment guidelines with the aim of reducing patient disease burden to the greatest extent possible.

Keywords: abortive; illicit substances; preventive; psilocybin; side effects.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
The number of prescribed abortive treatments tried. ECH = episodic cluster headache (n = 225); CCH = chronic cluster headache (n = 82); NA = subtype not available (n = 1). Individuals who did not reply to any of the questions regarding acute treatment were excluded from this analysis (n = 6).
Figure 2
Figure 2
Usage (A) and effect (B) of prescribed abortive treatments in cluster headache. (A) Usage of drugs to abort a cluster headache attack, proportions are reported as % of the respondent cohort. (B) Effect of drugs used to abort a cluster headache attack with percentages based on the study participants who had actively tried the substance in (A). * Anervan Novum contains Ergotamine, Chlorcyclizine and Caffeine. ** Treo Comp contains acetylic acid and codein.
Figure 3
Figure 3
Effect of non-prescribed substances used to abort a cluster headache attack. Proportions are reported as % of the respondent cohort.
Figure 4
Figure 4
The number of prescribed preventive treatments tried. ECH = episodic cluster headache (n = 229); CCH = chronic cluster headache (n = 82); NA = subtype not available. Individuals who did not reply to any of the questions regarding acute treatment were excluded from this analysis (n = 2). Preventative treatments did not include nerve interventions.
Figure 5
Figure 5
Self-reported usage and effect of preventive and transitional treatments for cluster headache. (A) Usage of drugs to prevent cluster headache (CH) attacks/bouts, proportions are reported as % of the respondent cohort. (B) Effect of drugs to prevent CH attacks/bouts with percentages based on the study participants who had actively tried the substance noted in (A).
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References

    1. Negro A., Sciattella P., Spuntarelli V., Martelletti P., Mennini F.S. Direct and indirect costs of cluster headache: A prospective analysis in a tertiary level headache centre. J. Headache. Pain. 2020;21:44. doi: 10.1186/s10194-020-01115-4. - DOI - PMC - PubMed
    1. Steinberg A., Josefsson P., Alexanderson K., Sjöstrand C. Cluster headache: Prevalence, sickness absence, and disability pension in working ages in Sweden. Neurology. 2019;93:e404–13. doi: 10.1212/WNL.0000000000007787. - DOI - PubMed
    1. Petersen A.S., Lund N., Snoer A., Jensen R.H., Barloese M. The economic and personal burden of cluster headache: A controlled cross-sectional study. J. Headache Pain. 2022;23:58. doi: 10.1186/s10194-022-01427-7. - DOI - PMC - PubMed
    1. Coppola G., Abagnale C., Sebastianelli G., Goadsby P.J. Pathophysiology of cluster headache: From the trigeminovascular system to the cerebral networks. Cephalalgia. 2024;44:03331024231209317. doi: 10.1177/03331024231209317. - DOI - PubMed
    1. Belin A.C., Barloese M.C. The genetics and chronobiology of cluster headache. Cephalalgia. 2023;43:3331024231208126. doi: 10.1177/03331024231208126. - DOI - PubMed

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