Approximately .4 percent of Americans have cluster headaches---mainly men. The headaches start when they are anywhere from 20 to 40 years old, according to Stephen Silberstein, M.D., professor of neurology at Thomas Jefferson University, in "The Merck Manual for Healthcare Professionals." Cluster headaches usually occur every day, but especially at night. The pain can be so severe that people wake from sleep. There are different kinds of remedies available.
Serotonin Agonists
Receptors are protein molecules that are on cell membranes or inside of cells. Their purpose is to receive signals that tell them what to do. An agonist always stimulates a receptor. A serotonin agonist stimulates receptors and tells them to release a substance called serotonin. Serotonin is 5-hydroxytryptamine or 5-HT. It is in many tissues and cells of the body, including the nerve cells of the brain. Serotonin decreases pain. Roger Simon, M.D., chair of neurology at Legacy Health Systems, writes in "Clinical Neurology" that there are several serotonin agonists used as remedies for cluster headaches. They include sumatriptan, natriptan, rizatriptan and several others. People can take these medications as pills or intranasal spray. Sumatriptan can also be injected.
Calcium Channel Antagonists
Antagonists do not stimulate receptors. They block receptors to prevent them from being stimulated. All calcium channel antagonists will block so calcium cannot stimulate. This results in relaxed muscles. Verapamil and flunarizine are two remedies that are used. Both can be taken in pill form. In "Clinical Neurology," Simon writes that physicians mainly prescribe verapamil for cluster headaches.
Ergot Alkaloids
As explained by Bertram Katzung, M.D., Ph.D., professor in the Department of Cellular and Molecular Pharmacology at the University of California, in "Basic & Clinical Pharmacology," this remedy is actually derived from a fungus that is found in damp grass. Ergot alkaloids act on several different types of receptors in the body. Pharmacologists believe that they are useful remedies for cluster headaches because they act on the serotonin receptors. Ergotamine is an ergot alkaloid. It is sometimes combined with caffeine so it can be absorbed quicker. It can even be taken as a rectal suppository at bedtime for people who suffer from severe nighttime cluster headaches. Dihydroergotamine is an ergot alkaloid remedy that people can take as an intranasal spray or injection.
Predisone
Prednisone is another remedy for cluster headaches, according to Dr. Silberstein in "The Merck Manual for Healthcare Professionals." Prednisone is a corticosteroid. These are hormones that are made in the outer part of the adrenal gland, called the adrenal cortex. Prednisone stimulates proteins within the body that fight against inflammation. The medication also suppresses proteins that are part of an inflammatory response. It is taken as a pill.
References
- "Basic & Clinical Pharmacology"; Bertram Katzung, M.D., Ph.D., Susan Masters, Ph.D., Anthony Trevor, Ph.D.; 2009
- "Clinical Neurology"; Roger Simon, M.D., David Greenberg, M.D., Ph.D., Michael Aminoff, M.D.; 2009
- "The Merck Manual for Healthcare Professionals": Cluster Headache
