Cluster headache therapy explained

An acute treatment is used when an attack starts, while preventive treatment is taken according to a clinician's plan to reduce attacks during a cluster period. The right choice depends on your symptoms, examination, other conditions, medicines, and how quickly attacks develop. Cluster headache is different from many ordinary headaches: severe pain around one eye may occur with tearing, nasal symptoms, eyelid changes, and restlessness, so a diagnosis should be checked before selecting treatment.

Therapy may involve more than tablets. Your clinician may discuss a fast-acting option, a preventive medicine, and how to monitor response or unwanted effects. Never change a dose, stop a preventive medicine suddenly, or use someone else's treatment without medical advice.

Arrange a GP consultation and describe how quickly each attack reaches its peak, how long it lasts, which side is affected, and what happens to the eye and nose. Record sleep disruption, alcohol or smoke exposure, medicines, and any heart, blood pressure, breathing, kidney, liver, or pregnancy-related considerations that could affect treatment choice. Ask for written instructions: what to use first, how to use it, when to repeat it if allowed, and what to do when it fails. Keep a diary so the clinician can decide whether the plan is helping and whether review is needed.

Get emergency help for a sudden explosive headache, weakness, confusion, fainting, seizure, speech difficulty, persistent loss of vision, fever with neck stiffness, or a painful red eye with reduced vision. Seek prompt review for a new diagnosis, a major change in attack pattern, troubling treatment effects, or repeated attacks despite following the plan. Do not drive if pain or visual symptoms make it unsafe.

Which treatment is for stopping an attack, and which is for prevention? How soon should each be used? What side effects need prompt advice? How will we review the plan, and what should I do if an attack breaks through it?