Posted by Dennis P. on April 16, 1999 at 15:48:41:
You may have already seen some of this information, and I do realize that some of it is crossover, but a Medline search for "cluster headaches treatment" found a few abtracts of articles about possible treatments. The articles themselves may be available at a local medical school or hospital library, and may be available through interlibrary loan.
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Gobel H, Lindner V, Heinze A, Ribbat M, Deuschl G. "Acute therapy for cluster headache with sumatriptan: findings of a one-year long-term study." Neurology 1998 Sep;51(3):908-11.
The efficacy, safety, and tolerability of subcutaneous sumatriptan in the acute treatment of cluster headache were investigated in a multicenter study over a period of up to 1 year. A total of 2,031 attacks were evaluated in 52 patients. Therapy was successful in 88% of all attacks. Freedom from pain within 15 minutes in more than 90% of all attacks treated was reported by 42% of the patients, and no decline in efficacy occurred during the course of the study. Adverse events were reported by 62% of the patients.
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It should be noted that sumatriptan was not found effective in cases of chronic paroxysmal hemicrania, which, from what I can gather, is a similar illness.
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An article in Clinical Journal of Pain 1998 Jun;14(2):97-106 found that capsaicin may be effective in treating cluster headaches.
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Lewis TA, Solomon GD. Advances in cluster headache management. Cleveland Clinic Journal of Medicine 1996 Jul-Aug;63(4):237-44, reported that verapamil (also known as calan or isoptin) "has revolutionized treatment."
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There's also this 1992 article from Neurology (its not all English to me but your physician might be able to interpret it): Mathew NT. "Cluster headache." Neurology 1992 Mar;42(3 Suppl 2):22-31.
In this article we describe the clinical features, natural history, and clinical variants of cluster headaches, following the modern International Headache Society classification of cluster headaches in its two types: episodic and chronic. The basic pathophysiology is considered to be the trigeminal vascular system, the common final pain pathway, with pain initiated in a cyclical fashion by disordered central hypothalamic pacemaker. Oxygen, rapidly acting ergotamine, or dihydroergotamine preparations serve as abortive treatment of acute attacks; various pharmacotherapeutic options and combination therapies aid in the prophylaxis of cluster headache; and trigeminal radio frequency gangliorhizolysis is a very useful surgical approach in
patients with chronic cluster headache who are resistant to medical treatment.
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There is a 1998 article titled "The treatment of cluster headache" from the journal Functional Neurology (1998 Oct-Dec; 13(4):279-84) by O. Sjaastad & R. Salvesen, but it does not have an abstract available.
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