Abortive Therapies for Cluster Headadache

Page by: E.J. Mayeaux, Jr., M.D.
Louisiana State University Medical Center Shreveport, Louisiana


Oxygen - 7 L/min for about 10 min - Patient should be seated, leaning forward, sinuses draining.

Dihydroergotamine - Usually 0.5 to 1.5 mg IV or IM in - Often coadministered with metoclopramide or other antiemetic.

Surnatriptan succinate - 6 mg SC; may repeat once after 1h (up to 12 mg/d) - Do not use with ergot alkaloids,- contraindicated in patients with uncontrolled hypertension, history of MI, ischemic or structural heart disease, cerebrovascular disease, pregnancy.

Lidocaine nose drops (4%) - 15 drops into affected side with may repeat in 15 min if necessary, up to twice per headache and up to four times per day - May cause dizziness and nervousness. Before use, may give 0.5% phenylephrine hydrochloride nose drops to clear congestion


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