Just returned from my Doctors surgery.

Having another bout of cluster headaches. I think my GP has now realised that what I've been saying after researching this condition is legit and I'm not making it up. Diagnosed with migraine for so long and prescribed amitriptyline for years. Hopeless.

This latest occurrence has been going on for four weeks now and reached its intensity earlier this week when the pain was that bad I attended an emergency clinic.

The attacks are at there worst at around 4am in the morning, regular as clockwork and boy it this the pain from hell. I'm exhausted.

I've been taking rizatriptan at the on-set of an attack, which does bring some relief if caught in time, however, my Doctor has now prescribed pizotifen and I'll take one tonight and see how these go?

Sorry, if what I've said has been covered elsewhere here, but I decided to jump right in and post to this board as soon as I found you.

Happy I've found this community to share thoughts and experiences on this mother of all conditions.

FIRST. Please tell us where you live. Follow the next line to a message which explains why knowing your location and your medical history will help us to help you.

Cluster Headache Help and Support › Getting to Know Ya › Newbies, Help us...help you
You can add your location by editing your profile. CP Member --> profile
BUT, Please!, don't post your messages at this location. They won't get the attention you want: use the appropriate sections which follow.
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I'm guessing you are in the UK. IF so, please contact your excellent support group: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
They can help you work with your health system and, if my guess is right, you also have a right to ask for treatment at any headache clinic of your choice.
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Since we are flying a bit blind at this point, just some general information about Cluster.

Pizotifen is for migraine; has no application for cluster.

Print out the PDF file, below. Provides the latest evaluations of Cluster meds. Give to your current doc.

Print out:



Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
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A couple of sites which are worth your attention: medical literature, films, plus the expected information
about CH.

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
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Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or Search under "cluster headache"
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The complexity of headache is such that a good diagnosis is essential before you get involved in attempting to develop a treatment plan. Far too many docs lack education/experience with Cluster and so many folks have taken years to find a skilled doc.

No need to go on until we have a clear picture of your medical situation--skill or present doc, where you are located, etc.