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Recommended Acute Cluster attack treatments
Treatment |
Formulation |
Strength |
Maximum Daily Dose |
Oxygen |
Inhalation through non-rebreathable mask |
7-15 L/min |
No limit |
Sumatriptan |
Subcutaneous injection |
6 mg |
12 mg |
Sumatriptan |
Nasal spray |
20 mg |
40 mg |
Zolmitriptan |
Nasal spray |
5 mg |
15 mg |
Non-invasive vagal nerve stimulation |
Transcutaneous |
As per specialist recommendation |
Recommended preventive treatments for cluster headaches
Name |
Start dose |
Titration |
Max daily dose |
Comments |
Greater occipital nerve block |
Depot steroid + local anaesthetic |
Not applicable |
Not applicable |
Different formulations of steroid & anaesthetic used* |
Verapamil |
80 mg TDS |
Increase 80 mg every 2 weeks |
960 mg |
ECG monitoring recommended |
*There does not seem to be a difference between different local anaesthetics