Story by: David Steen Martin on January 25, 2021
Cluster headache medication can reduce the extreme pain of these episodic headaches, as well as the frequency.
Active periods of cluster headaches can last one week to several months, with pain-free periods of at least three months. Several headaches per day are not uncommon. The attacks average 30 minutes, but they can last anywhere from 15 minutes to three hours.
“The pain associated with episodic cluster headache is the most severe pain humans can experience,” said neurologist Brian M. Plato, D.O., headache and migraine specialist with Norton Neuroscience Institute. “Women tell me childbirth is less painful.”
Cluster headaches typically strike without warning, with excruciating pain behind one eye. In addition to pain, these headaches can cause the eye to tear up and the eyelid to droop. There can be swelling. The person experiencing a cluster headache may have a stuffy or runny nose on the affected side.
Injections of sumatriptan, which goes by the brand name Imitrex, is an effective way of stopping a cluster attack, though insurance companies typically limit patients to six doses per month, according to Dr. Plato.
Another effective way to end an attack is breathing 100% oxygen, though Medicare will not cover this for people with episodic cluster headaches, according to Dr. Plato. Private insurers tend to follow Medicare’s lead on what to cover, but it’s worth checking with your insurance provider.
Another drug, galcanezumab (brand name Emgality), has been shown to reduce the number of attacks per week. The drug doesn’t end the cycle but makes it more bearable by reducing the number of attacks.
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Episodic cluster headaches are rare, affecting only one in 1,000 people. They often go undiagnosed, or they are misdiagnosed as migraine or sinusitis, according to Dr. Plato.
The cause of cluster headaches is unknown, but men are more likely to have cluster headaches than women, as are smokers and people who have a parent or sibling with cluster headaches.
Episodic cluster headaches aren’t associated with a particular trigger, such as stress, but drinking alcohol during a cluster period may increase the risk.
“Patients who have episodic cluster headache live a part of their life in absolute fear of what happens when this comes back,” Dr. Plato said. “It’s not uncommon the attacks will awaken individuals from sleep. When they’re in a cycle, patients will fear sleep because a couple of hours later they will awaken with a severe attack.”
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