Preventive
Preventive treatments are used to provide the sufferer with a long-term reduction or elimination of the cluster headaches. These techniques are generally used in combination with abortive and transitional techniques in order to obtain the best therapeutic results.
The calcium channel blocker Verapamil is a first-line recommended preventative therapy. Dosages of 360–480 mg daily have been found effective in reducing Cluster headache attack frequency. Despite its success in randomized controlled trial, only 4 percent of patients with cluster headache report verapamil use. Current European guidelines suggest the use of the drug at a dose of at least 240 mg daily.
Methysergide, lithium and the anticonvulsant topiramate are recommended as alternative treatments. Additionally, Magnesium supplements have been shown to be of some benefit in about 40% of patients who have low serum levels of magnesium.
Anecdotal evidence also suggests Vitamin D3 may assist in preventing cluster headaches by inhibiting nitric oxide production.
Read more about this topic: Cluster Headache Treatments
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