The intensity of each individual episode of cluster headaches is so high that their treatment should focus primarily on prevention. Due to the short duration of attacks of cluster headaches, most symptomatic drugs do not have time to act, and the attacks end spontaneously.
Recommendations for specific treatment vary depending on the nature of cluster headaches – from an episodic or chronic course. The duration of episodic attacks is> 7 days, periods of remission> 1 month. With an episodic form of the disease, the pain period lasts on average 6 weeks. Chronic cluster headaches last longer than 1 year with periods of complete remission of less than 1 month per year.
Prevention of episodic cluster headaches should begin at the first appearance of an attack and continue throughout the cluster period. It is noteworthy that some patients suffering from persistent episodic cluster headaches may experience the prophylactic benefit of long-acting triptan (for example, frovatriptan), consumed overnight.
If cluster headaches are first detected in the developed stage of the pain bundle, usually there is a need for short courses of steroid drugs. For prophylactic treatment of headaches of the subsequent pain period (beam), it is necessary to work out its plan in advance.