Symptom Finder - Treatment of Acute Cluster Headache
HEADACHE, CLUSTER, ACUTE
1. Sumatriptan (Imitrex): 25–50 mg p.o. or 6 mg subcutaneously andmay repeat oral or SC dose once more in 24 hours.
2. Alternatively may prescribe other 5-HT receptor agonists
3. If these are ineffective give oxygen 6 L/min preferably by mask.
4. Analgesics such as morphine sulfate 10–15 mg IM or meperidine
(Demerol) 50–75 mg IM may be necessary. Alternatively butorphanol (Stadol) 1–4 mg IM or IV may be given q3–4hrs PRN.
Prophylaxis:
1. Prednisone: 60–80 mg daily for 2–3 weeks and gradually taper over 4–6 weeks.
2. Alternatively calcium channel blockers such as verapamil SR (Calan) 120–240 mg bid or indomethacin (Indocin) 25–50 mg qid may be tried.
3. Avoid caffeinated beverages and nicotine.
1. Sumatriptan (Imitrex): 25–50 mg p.o. or 6 mg subcutaneously andmay repeat oral or SC dose once more in 24 hours.
2. Alternatively may prescribe other 5-HT receptor agonists
3. If these are ineffective give oxygen 6 L/min preferably by mask.
4. Analgesics such as morphine sulfate 10–15 mg IM or meperidine
(Demerol) 50–75 mg IM may be necessary. Alternatively butorphanol (Stadol) 1–4 mg IM or IV may be given q3–4hrs PRN.
Prophylaxis:
1. Prednisone: 60–80 mg daily for 2–3 weeks and gradually taper over 4–6 weeks.
2. Alternatively calcium channel blockers such as verapamil SR (Calan) 120–240 mg bid or indomethacin (Indocin) 25–50 mg qid may be tried.
3. Avoid caffeinated beverages and nicotine.
