While there is no cure for cluster headaches, treatment can effectively reduce the frequency and severity of your headaches. You don't have to live with the excruciating pain of these headaches. Treatment depends on the frequency of headache cycles and the severity of symptoms during a cycle.

Initial treatment

Treatments to stop cluster headaches that have already started are called abortive headache treatments. They include abortive headache medicines and an oxygen therapy. Abortive treatments relieve pain and reduce the severity of symptoms once the headaches begin. Abortive headache treatments used most often to stop a cluster headache include:

• Ergotamine preparations, such as ergotamine tartrate with caffeine (Cafergot, Wigraine), which narrow blood vessels to relieve pressure and reduce headache pain.
• High-flow oxygen inhalation therapy, in which you breathe oxygen through a face mask to reduce blood flow to the brain and relieve headache pain. Around 7 in 10 people treated with oxygen soon after the start of a headache get relief within 10 to 20 minutes.³ But you need to repeat the treatment when the next headache begins.
• Intranasal lidocaine, which is taken by nose drops to stop severe headache pain.
• Sumatriptan (Imitrex), which is usually injected to narrow blood vessels and reduce pressure and pain. This medication can also be taken as a nasal spray, although it may be less effective than the injection.

Medicines used to prevent cluster headaches or reduce the number of headaches in a cycle are called prophylactic headache medicines. Prophylactic headache medicines most often used to prevent cluster headaches include:

• Calcium channel blockers, such as verapamil hydrochloride (Calan, Isoptin, Verelan), which widen narrowed blood vessels and reduce pain. Verapamil hydrochloride is commonly used for preventing both occasional and chronic cluster headaches.³
• Corticosteroids, such as prednisone, which can break a headache cycle, although it is not clear how these medications work.
• Lithium. Lithium carbonate (Lithobid, Lithonate, Lithotabs, Eskalith) is thought to affect the brain's biological clock (hypothalamus), which some experts think is linked to cluster headaches, although the specific problem or abnormality that triggers cluster headaches is unclear. Lithium is often prescribed to prevent chronic cluster headaches.
• Antiseizure medications such as divalproex sodium (Depakote), valproate (valproic acid), or topiramate (Topamax), which may be tried if other treatments are not effective.

It may be helpful to identify and avoid headache triggers such as alcohol, cigarettes, and raising your body temperature with hot baths or exercise during a headache cycle. For more information, see:

How can I effectively manage a headache?

Keep track of when your cluster headaches happen, how often they happen, how severe your symptoms are, and what you think may be causing the headaches. Write it all down in a headache diary(What is a PDF document?). Take this written record with you when you visit your doctor, because it can provide valuable information to guide your treatment.