Prevention
A wide variety of prophylactic medicines are in use, and patient response to these is highly variable. Current European guidelines suggest the use of the calcium channel blocker verapamil at a dose of at least 240 mg daily. Steroids, such as prednisolone/prednisone, are also effective, with a high dose given for the first five days or longer (in some cases up to 6 months) before tapering down. Methysergide, lithium and the anticonvulsant topiramate are recommended as alternative treatments. In Australia, neurologist John Watson has also reported success with sodium valproate and carbamazepine in some chronic, treatment-refractory cases.
Intravenous magnesium sulfate relieves cluster headaches in about 40% of patients with low serum ionized magnesium levels. Melatonin has also been demonstrated to bring significant improvement in approximately half of episodic patients; psilocybin, dimethyltryptamine, LSD, and various other tryptamines have shown similar results.
Read more about this topic: Cluster Headache
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“... if this world were anything near what it should be there would be no more need of a Book Week than there would be a of a Society for the Prevention of Cruelty to Children.”
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