Headaches: Cluster - Managing Cluster Headaches

Other agents that have been tried include indomethacin, melatonin, beta blockers, tricyclic and other antidepressants, and capsaicin. Combinations may be needed.

Behavioral Treatments

Lifestyle Changes. Patients should avoid the following:

• Alcohol.
• Foods containing nitrates or nitrites (such as smoked meats). No other dietary factors appear to play a role, for good or ill, in this disease.
• Medications containing nitrates (such as nitroglycerin).
• Smokers who can't quit should at least stop at the first sign of an attack and not smoke throughout a cycle.

One study suggested that vigorous physical exertion at the sign of an attack onset may help reduce or even abort an attack.

Surgery

Surgery may be considered for patients with chronic cluster headaches that do not respond to medications. It should be noted, however, that surgery is also limited in its effectiveness.

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