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In what form does Imitrex (sumatriptan) work best?

That depends on the individual situation and also a little on the personal taste. The fastest and safest effect is the injection under the skin. There are pre-filled syringes that are easy to apply and hardly hurt. The nasal sprays have a similar effect, provided you spray properly (follow the instructions exactly!).

The simplest and most convenient is certainly the tablet intake. The disadvantage of sumatriptan's low "oral bioavailability" (a significant portion of the drug does not reach the blood when ingested via the gut because it is previously metabolized by the liver to inactive metabolites) is more of a theoretical nature for migraine sufferers is taken into account in the tablet dose. Of greater concern is the problem that the tablets may be "lost" in severe nausea. For those who often suffer from nausea and vomiting during their migraine attacks, the nasal sprays, suppositories or syringes are usually the better option.

Cluster Headache: Causes and Therapies

Like a throb of pain in the head, some people describe the cluster headache. "Like knife cuts in the eye" so explain him others. The exact causes of this headache are not yet known. But there are effective ways to relieve pain and prevent cluster headache.

Almost everyone has a headache. For most, it remains a pain that can get back well with the appropriate active ingredients. However, some people suffer from headaches that are extremely severe and can last for several hours. Cluster headaches usually occur quite suddenly and then paralyze the person's life from one minute to the next.

What are cluster headaches exactly?

"Cluster" comes from English and means "accumulation" or "aggregation". This is to express that pain is characteristically concentrated on one half of the face, or more precisely behind the eye. Another term for cluster headache is Bing Horton Headache.

Cluster headache is a type of headache that is extremely painful and occurs in spurts. Affected complain about veritable pain attacks that can occur several times a day. Cluster headache is considered the most painful of all known headache types.

Typical of cluster headache: it occurs in phases. During the pain phases it comes again and again to sudden attacks of pain. In between, there may be phases in which the patient does not experience a cluster headache for a long time. These periods can be a few weeks to a year.

Cluster headaches can be episodic or chronic:

Episodic cluster headache: Cluster headache alternates with symptom-free phases and lasts for a maximum of one year.
Chronic Cluster Headache: The attacks last longer than a year. There are no complaints-free intervals and if so, they are shorter than four weeks. Due to the severe pain and the resulting high level of suffering, this form is also referred to as suicide headache.
Who is at risk?
When the cluster headache first appears, those affected are usually between 20 and 40 years old. Men are more frequently plagued by this type of headache than women. Smokers also have an increased risk of getting it.

Cluster headache rarely occurs. Statistically, one in 500 to 1,000 people suffers from it. By comparison, about ten times more people have migraine attacks on a regular basis.

Migraine: What role does nutrition play?

What symptoms are typical of cluster headache?
Cluster headache has a number of characteristic signs that clearly distinguish it from other headache types.

Typical of cluster headache are the following symptoms:

The pain always occurs in the same place - usually behind one and the same eye. The pain often radiates towards the nose, forehead, temple or neck.
The pain always occurs at the same time of day. Often sufferers complain after getting up in the morning about pain attacks.
The pain usually occurs very suddenly and returns in spurts. On one day, those affected can suffer up to eight attacks of pain lasting between 15 minutes and several hours.
An eye swells and tears. The pupils narrow. The eyelid and nasal mucosa also swell.
The affected person is ill and he feels inner turmoil.
It is also typical for cluster headache that the attacks occur mainly in autumn and spring.

What causes cluster headache?

What exactly causes cluster headache is still unclear. However, genetic factors seem to play a major role in its development. It is certain that the pain attacks occur as soon as inflamed blood vessels in the brain widen.

Experts also suspect that behind the disease is a disturbed day and night rhythm. This is the linkage of the headache with a certain time of day.

Furthermore, the researchers were able to pinpoint certain triggers for headache attacks. Among the best known are ...

Nitroglycerin: the agent is used in medicine as a means of vasodilation
Histamine: an endogenous substance that plays a major role in allergies and immune defense. Therefore, cluster headache is also called histamine headache.
Alcohol: A small amount of it promotes the onset of pain. Drinking but drinking a lot of alcohol at once, this reduces the likelihood that in the near future, a pain attack occurs. How it comes to this contrasting effect of alcohol is not yet known. However, alcohol is by no means suitable for preventing cluster headache - the associated side effects are too great.
Those suffering from cluster headache should pay attention to their diet and avoid foods that either contain high levels of histamine or promote the production of histamine in the body. This applies, for example, to strawberries, red wine, tomatoes or chocolate.

Histamine Intolerance: What else can I eat?

It is also known today that during a headache episode certain external factors trigger a pain attack (technical term: trigger). These include, for example ...

big heat (in the summer or in the sauna)
dazzling or flickering light
strong noise and
Height differences, as they occur when traveling from the lowlands to the mountains.

What is pain and what happens in the body?

The diagnosis of cluster headache
The basis of the diagnosis is in most cases the symptoms. Imaging procedures such as X-rays are not suitable for properly detecting cluster headache.

Patients often suffer from the pain for years before the diagnosis "cluster headache" can be made. Ideally, they can be examined in a medical facility that specializes in headaches or pain in general (for example, a pain clinic).

Document symptoms

The doctor is easier to diagnose if the patient can describe the pain attacks as accurately as possible. It therefore makes sense to keep a "pain diary" over a few months, listing the frequency, cause and duration of cluster headaches.

The records make it easier to see if it is cluster headache and what events or substances are the trigger.

How to treat cluster headache?
Cluster headache can not be alleviated by conventional analgesics. This is particularly distressing for sufferers who have not yet been diagnosed with the condition. During a pain attack, they try to deal with classic painkillers complaints. If they eventually go away on their own, those affected are tempted to attribute this to the drugs. They did not have any influence on this, but only added weight to the organism due to their side effects.

Lidocaine (a local anesthetic), on the other hand, has proven to be an effective treatment for cluster headache. It is injected into the nose or near the irritated nerves. Another remedy for acute pain attacks is the drug sumatriptan. He has an influence on how Serontonin is used in the body. This messenger substance (technical term: neurotransmitter) is involved in pain processing. Side effects of sumatriptan treatment may be dizziness, low blood pressure and tiredness.

A therapy that is both side-effects and tremendously effective is the inhalation of pure oxygen. In an acute pain attack, sufferers inhale the noble gas for about a quarter of an hour. Then, with a probability of 80 percent, they no longer have any pain. The earlier applies to a pain attack, the oxygen inhalation, the more successful the treatment.

Relaxed by respiratory therapy

Can cluster headache be prevented or even cured?
If you want to prevent a pain attack, it is of course, the known triggers (for example, alcohol or histmaninreiche food) as far as possible to avoid.

In addition, to prevent cluster headache, sufferers can take the active ingredients verapamil or lithium. The latter, however, sometimes has significant side effects such as concentration problems, weight gain and increased urinary frequency.

However, there is no treatment that can completely cure or cure cluster headache. Only a relief or prevention are possible.

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