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Cluster Headache Help and Support › Getting to Know Ya › Newbies, Help us...help you
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Sounds like you have found doc who knows the basics of treating Cluster. The steroid works quickly to stop attacks but it's used for only a few days. AT THE SAME TIME, he should have been given a preventive med which is used continuously (during periods when attacks are active). This med reduces the intensity and/or frequency of attacks. You continue to use the aggressive abortive med when an attack breaks thru.

Se the PDF file, below, for the most common meds used. You may print it out and used as a tool to discuss your options with the doc.

Learning about Cluster is your best defense so explore the buttons, left, starting with the OUCH site; read the many messages here, as you have time.

A couple of sources of basic information:




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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As specific issues/questions develop, please stay in touch. Our folks have some deep experience to offer to you, medical information, etc.

Welcome, Lou; and thank you for being there for your husband. Our supporters are vital to our well being. As you check out the site, please pay special attention to the "oxygen info" link. When coupled with Red Bull, or some other energy drink with at least 1000mg of taurine, it reduces abort times dramatically. Good luck and God bless. lance

Hi Lou

First time I've seen anyone posting here from Roto-Vagas (which'll confuse a few people). Thanks for visiting for your husband. You will soon have learnt a lot more than most doctors know here and will be able to help to get him good, effective treatment for his CHs.


Dealing with CH you need a good preventive. I use verapamil with most people needing 360-480mg a day, although some go to double that dose. There are others like lithium too, which will prevent some of your CHs from happening.

Most preventives take a bit of time to build up, so it's common to use a prednisione taper (probably the steroid you mentioned), starting at about 60mg and tapering off to nothing over 10 days or so. This will work as a good preventive whilst the longer term preventive builds up. Just don't let him stay on it too long as prednisione isn't good to your body long term.

Once he gets a CH he wants to kill it as quick as possible. Imigran will do this, but oxygen is even better and it doesn't have any of the side effects of imgran. It isn't too easy to get this in NZ, however people I've spoken to here in NZ have got it. You can ready about how I got mine - Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Most people here once they've got oxygen working well find they use the imgran (imitrext) injections a lot, lot less as it's about the same time to take effect and it's a lot less in the way of side effects too.

If he has nothing else around, try using a Red Bull or similar energy drink with taurine and caffeine. Just drink it right as a CH hits and you can normally reduce the intensity and duration of a CH. For a bad CH I'll combine it with the oxygen too.

Also read this thread - Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or - it can work well as a preventive too.

Keep reading and keep asking questions... Hopefully his CH's will vanish quickly this time as spring is here and he'll want to enjoy the better weather.

Hi Lou
Welcome & thank you for being a supporter.

Supporters are just as important to us as the best headache specialist you can find.

As for Brian he is just overflowing with Culcha beyond normal belief.

Cheers from over the ditch & a bit further west of Brian.

Barry