Cluster headache primary prevention: Difference between revisions
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{{CMG}} {{AE}} {{SAI}} | {{CMG}} {{AE}} {{SAI}} | ||
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== Overview == | |||
The drug of choice for primary prevention of cluster headache is Verapamil. Other agents that can be used also include glucocorticoids, topiramate and lithium. | |||
== Primary Prevention == | |||
==== Verapamil: ==== | |||
* Mostly used for episodic and chronic cluster headache | |||
* Usually starts with a dose of 240 mg and can be titrated upto 480 mg to 960 mg , depending upon the tolerance Dose is usually increased by 80mg every 10-14 days | |||
* An EKG is recommended before starting the treatment as Verapamil can cause EKG changes such as heart block and bradycardia, with a total daily dose of 480mg. | |||
* Side effects include: edema, gastrointestinal discomfort, constipation, dull headache, and gingival hyperplasia | |||
==== Glucocorticoids: ==== | |||
* Several open label studies have shown that glucocorticoids have reduced the frequency of cluster headaches | |||
* Prednisone 30 mg daily or a higher dose can be used | |||
* Dexamethasone 8 mg daily in two divided doses | |||
==== Topiramate: ==== | |||
<br /> | |||
==== Lithium: ==== | |||
'''Galcanezumab:''' | |||
<br /> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 09:55, 22 May 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sabeeh Islam, MBBS[2]
Overview
The drug of choice for primary prevention of cluster headache is Verapamil. Other agents that can be used also include glucocorticoids, topiramate and lithium.
Primary Prevention
Verapamil:
- Mostly used for episodic and chronic cluster headache
- Usually starts with a dose of 240 mg and can be titrated upto 480 mg to 960 mg , depending upon the tolerance Dose is usually increased by 80mg every 10-14 days
- An EKG is recommended before starting the treatment as Verapamil can cause EKG changes such as heart block and bradycardia, with a total daily dose of 480mg.
- Side effects include: edema, gastrointestinal discomfort, constipation, dull headache, and gingival hyperplasia
Glucocorticoids:
- Several open label studies have shown that glucocorticoids have reduced the frequency of cluster headaches
- Prednisone 30 mg daily or a higher dose can be used
- Dexamethasone 8 mg daily in two divided doses
Topiramate:
Lithium:
Galcanezumab: