Corticosteroids for cluster headaches

Corticosteroids (such as prednisone or dexamethasone) are referred to as "transitional" medications for the treatment of cluster headaches because they are sometimes used to break a cycle of cluster headaches. They are paired with medications that stop (abortive) or prevent (prophylactic) additional headaches during a headache cycle. Often, within 2 to 4 days after starting treatment with corticosteroids, you will become headache-free. By the time the corticosteroids are stopped-their use is often tapered within 6 to 8 weeks of starting and then discontinued-the medications used to prevent cluster headaches have become effective.

Prednisone provides substantial relief from occasional episodes of cluster headaches in about 77% of those who take it during a headache, and it is effective in about 40% of people with chronic cluster headaches.¹ Dexamethasone is also an effective treatment until the preventive (prophylactic) medications become effective. Unfortunately, the headaches often come back when you stop taking a corticosteroid or reduce the dosage.

Corticosteroids are not used over a long period of time because they can cause serious side effects, including:

• Weight gain.
• High blood pressure.
• High blood sugar levels.
• Cataracts.
• Osteoporosis.
• Stomach ulcers.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Citations

1. Rozen TD (2002). New treatments in cluster headache. Current Neurology and Neuroscience Reports, 2(2): 114–121.