Therapy
In the case of a seizure, patients are supplied with high doses of oxygen via a face mask for a period of about 10 minutes. The administration of an ergotamine preparation as an injection under the skin or as a nasal spray can also prove helpful, and a lidocaine nasal spray can also be used. Unfortunately, the response rate to the individual drugs is sometimes rather low.
To prevent further seizures, various drugs from different active substance groups are used. Verapamil (an antihypertensive), methysergide (a former migraine drug), or valproic acid (from the treatment of epilepsy) are used. Short-term therapy with cortisone (cortisone) or the intake of lithium can also prove helpful.
In acute therapy during a cluster headache attack, undiluted oxygen is administered together with the drugs sumatriptan, which is injected under the skin, and zolmitriptan, which is given by nasal spray. These drugs are considered the first choice in the treatment of an attack. The two drugs belong to the group of triptans, which cause a narrowing of the cerebral vessels.
In the acute phase, lidocaine can also be administered by nasal spray. It has a local effect on the pain trigger and is used here as a second choice. As a prophylaxis, Verpamil, a drug which has a vasodilating effect in the arteries and still has a good effect, can be administered as first choice.
As a second choice lithium can be given as prophylaxis, which can positively change the brain metabolism and therefore also the nerve irritation. Homeopathy is not considered effective for cluster headaches. Just like relaxation techniques, physiotherapy or other complementary medical measures.
For other pain disorders, these techniques, like homeopathy, have their justification. Cluster headache, however, should be treated in a fundamentally different way, as it does not respond to the usual painkillers either. With homeopathy, it is generally the case that it does not have any side effects and therefore no doctor has anything against it.
The patient should be informed that in this case homeopathy is not considered to be effective, but he or she can decide for themselves whether they benefit from it. “Potassium iodatum” is recommended by homeopaths in this case, as are some other remedies. The cluster headache is still under investigation.
However, it has so far been shown that it can be treated by administering one hundred percent oxygen. During a pain attack, the patient receives undiluted oxygen for inhalation directly from the gas bottle or the gas connection from the wall. Together with the drug sumatriptan, which is injected under the skin, and zolmitriptan, which is administered by nasal spray, it is considered the drug of choice.
Cluster headache is one of the most aggressive types of pain that cannot be treated with even the strongest painkillers such as opiates (morphine, etc.) and can only be controlled by specific other drugs. All patients should therefore consult a doctor and be treated with modern means.
However, anyone who wants to do something at home about cluster headaches, especially as a prophylaxis, should avoid nicotine and alcohol. This is particularly recommended during the cluster periods. Both the drugs zolmitriptan and lidocaine, which are used in the acute therapy of cluster headaches, can be administered as a nasal spray.
In this way, the active substance is absorbed quite quickly directly through the nasal mucous membranes, which is an advantage in acute therapy. Zolmitriptan constricts the vessels in the brain while lidocaine blocks the pain transmission. However, lidocaine is only administered as a second choice in acute therapy.
