Read our EiC’s message in full below:

Today we share some thoughts about cluster headache, namely the “worst pain that man ever knows” and spreading awareness on this lethal headache disorder.

As time goes by, more and more cluster headache patients step out of the shadow, the same patients that once, I remember, were destined to a life of resignation, with inappropriate, wild and however unsuccessful self-medication until an unavoidable psychiatric support.

They have been forgotten for decades. We, as dedicated experts and specialists that face this pathology every day, have now the chance to offer these patients an awareness window and new effective therapeutic opportunities. We cannot miss this call.

The therapeutic management of cluster headache is based on a very stable triad of drugs. Acute treatment is based on subcutaneous sumatriptan as gold standard if compared with pure oxygen or indomethacin. Preventative treatment is based on verapamil at high doses as gold standard if compared with lithium carbonate or topiramate. Transitional treatments based on the short-term use of corticosteroids with either systemic or local administration can be useful for the suppression of most resistant cluster periods, but with a well-known carry-over phenomenon related to the length of the cluster period itself.

The role of neuromodulation approaches, invasive or not, is still to be determined on large scale therefore it shouldn’t be suggested yet. Lifestyle changes, including alcohol avoidance during the active phase of the disease, sleep hygiene and vasodilation drugs use should be carefully considered and the patients should be fully informed.
New class-drugs CGRP related seems to offer, in the near future, a different quality in the treatment of this excruciating pain disorder.

We share related open access research here, in support of the global awareness campaign.