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Suggest treatment for cluster headaches

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Practicing since : 2005
Answered : 947 Questions
Hello there, My name is Nate and I have what sounds to be cluster headaches every day at least 3 times daily. My first one ever was in late 2005 or early 2006. I was in 7th grade P.E. Class when I felt like someone was taking a sharp object and pushing on the back of my eye. Prior to that I had suffered from tension and migraine headaches since I was little. After that day in 7th grade I've gotten them for about 5-9 months everyday, starting with one per day and then had gotten to about 2-3 per day during the cycles of 5-9 months. Writhing the past year they have gotten much worse with the last 4 months noticeably worse than ever before. Last week I had my worst one to date with the almost shut eyelid, completely red and teary eye, my temple vein looks like it will burst it pulsates so much and my neck is affected as well. This is all only on the right side of my head. I know when I will get on because I feel a small, about a 1/4 of an inch knot right under the back of my skull start to get tighter and larger. Now when that happens I can let it come slower by leaving it or if I crack my neck it brings the pain on in 30-60 seconds behind my eye and the temple area. It is excruciating. It has been affecting me in many ways including my job, mood and relationships. I feel it's causing some sort of depression/anger at times. I can't find a doctor that will even diagnose me with anything so I turned here for help. I really appreciate any response from anyone here. I'm just trying to find what it is if it's not cluster, how I can manage it better and hopefully end it all for good. Thank you and have a great day.
Posted Tue, 25 Feb 2014 in Brain and Spine
Answered by Dr. Manisha Gopal 6 hours later
Brief Answer: It is migraine, start medicine & you will be fine Detailed Answer: Hello and welcome to HCM! I have read your question and from my clinical experince I can say that --your symptoms are suggestive of severe migraneous headaches & it is completely manageable. It is on of the most common clinical symptoms seen in females. I think that you need to start medicine if you are not taking any right now...I have seen excellent response with dothiepin, in dose of 25-100 mg, taken preffrably at night.There can be some sedation with it initially, but it weans off with time.. this drug also takes care of mood changes and anger you are having. For acute attacks-- I prefer giving naproxen sodium with domperidone 500 mg SOS ( upto two times a day) or almotryptan. or rizatryptan You should also avoid triggers of migraine - like donot stay hungry, avoid sudden changes in temperature, reduce tea/ coffee/ chocolate and citrus fruits intake... It will help to get some tests - blood pressure, sugar levels, thyroid, lipid profile and X Ray neck (to rule out cervical spondylosis). Donot worry, you will be fine, see your doctor and discuss the above points. Hope the reply is useful Please feel free to ask more questions for clarifictaion Dr. Manisha Gopal MD psychiatry
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