Intro

Ideally, you will be under the care of a doctor familiar with this type of headache—a neurologist a pain physician, or a family doctor with special training with this type of headache.

• You and the doctor will work out a plan so you will know which types of pain you can deal with safely at home, which require a call to the doctor, and which require an immediate trip to a hospital' emergency Department.
• You should always bear in mind, however, that these headaches can be excruciating, and your doctor always will be there to help you.
• Notify the doctor when you get a severe headache that is not of the same type as the ones you are used to experiencing.
• Call your doctor if you develop a new side effect from the medications you are taking.
• If you have not ever had headaches, or have never seen a doctor for headaches, and have a sudden, severe headache, you should call your doctor or go to a hospital's emergency department.

Seek immediate medical attention or go to a hospital's emergency department under the following circumstances:

• When your current medication does not control the pain and you need immediate relief
• When your pain prevents eating and drinking and you become at significant risk of malnutrition or dehydration
• When you experience profound side effects from your medications such as severe drowsiness, sedation, and nausea and vomiting
• When a doctor advises you to seek evaluation and treatment for any of these problems
• When you have a change in the severity or increased frequency of headaches, or a headache that feels different from any previous headaches

Self-Care at Home

You can treat cluster headache at home under a doctor's care. Treatment involves 2 types of care, and many people require both at the same time:

• Preventive treatment: This includes ongoing use of medications proven effective in holding off headaches or limiting their number, even when you are not experiencing headaches. Examples are Drug like beta-blockers (Inderal), [Tenormin]), anticonvulsants [Topamax], divalproex , carbamazepine [Tegretol]), tricyclic antidepressants, nortriptyline, and calcium channel blockers. Though widely used, the selective serotonin reuptake inhibitor (SSRI) class of antidepressant [Prozac], paroxetine [Paxil], escitalopram [Lexapro]) is relatively ineffective for headache.
• Abortive treatment: This is designed to stop a headache once it has begun. medications include ergotamine (Bellamine, Cafergot), acetaminophen-isometheptene-dichloralphenazone (Midrin), dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray), and more recently, the drugs of the triptan family (almotriptan [Axert], eletriptan [Relpax], frovatriptan [Frova], naratriptan [Amerge], rizatriptan [Maxalt], sumatriptan [Imitrex], zolmitriptan [Zomig]).
• In addition, many medications used to treat migraine headache   (Excedrin Migraine Pain Reliever/Pain Reliever Aid, oxygen, prednisone [Deltasone]) can also be used for cluster headache.

Outlook

• Cluster headache can be either ongoing or come and go, and people can jump from one type to the other. Many people who have cluster headache are pain-free for a year or longer, only to have the frustrating cycle of daily headaches begin again.
• As is the case with migraine, people with cluster headaches respond to therapies that are widely available and are becoming less expensive. With proper medical treatment and guidance, you can control cluster headache