There are two primary treatments for acute CH: oxygen and triptans, but they are underused due to misdiagnosis of the syndrome. During bouts of headaches, triggers such as alcohol, nitroglycerine and naps during the day should be avoided. Oxygen Oxygen therapy may help to abort attacks, though it does not prevent future episodes. Typically it is given via a non-rebreather mask at 12–15 liters per minute for 15–20 minutes. One review found about 70% of patients improve within 15 minutes. The evidence for effectiveness of 100% oxygen, however, is weak. Hyperbaric oxygen at pressures of ~2 times greater than atmospheric pressure may relieve<unk> s. Triptans The other primarily recommended treatment of acute attacks is subcutaneous or intranasal sumatriptan. Sumatriptan and zolmitriptan have both been shown to improve symptoms during an attack with sumatriptan being superior. Because of the vasoconstrictive side-effect of triptans, they may be contraindicated in people with ischemic heart disease. The vasoconstrictor ergot compounds may be useful, but have not been well studied in acute attacks. Opioids The use of opioid medication in management of CH is not recommended and may make headache syndromes worse. Long-term opioid use is associated with well known dependency, addiction, and withdrawal syndromes. Prescription of opioid medication may additionally lead to further delay in differential diagnosis, undertreatment, and mismanagement. Other Intranasal lidocaine (sprayed in the ipsilateral nostril) may be an effective treatment with patient resistant to more conventional treatment. Octreotide administered subcutaneously has been demonstrated to be more effective than placebo for the treatment of acute attacks.
Cluster headache
Migraine
Lupus headache
Trigeminal neuralgia
Vascular headache
Trigeminal autonomic cephalgia
Tension headache
Medication overuse headache