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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Cluster Headaches?

I am 44 years old(female) and suffer from cluster headaches. It s been two years since my last headaches, I have been having them every night now for about two weeks. I am completely drained, extreme fatigue, no energy at all. Hard to concentrate and focus on my job. I m just so tired and just don t feel good. I didn t feel this way last time I had my cycle of cluster headaches, but last time they only lasted about a week. The only medicine I take is Maxalt which the doctor gave me for when I get a headache. Is it one of the side effects of the cluster headaches to feel so tired and run down? Any other things I should have checked out?
Fri, 5 Dec 2014
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Neurologist 's  Response
I read your query and I am sorry about what you are going through.
Regarding your question of whether it's normal of feeling tired and run down I would say that it is normal considering it has been for more than two weeks for every night.
On whether other diagnoses have been checked, while what you describe fits with cluster headache, you don't mention much about the headache itself, localization, onset and how long each episode, frequency of episodes, accompanying symptoms (tearing, eyelid swelling, stuffed nose etc), so I can't say for sure whether all criteria for cluster headache are fulfilled.
I do have suggestions to make about treatment though. It seems you get only treatment to abort the painful episode, but usually preventive treatment is employed as well which is more important. It should be started when a cycle begins and continued until you are headache free for at least 2 weeks, after that it is tapered slowly. There are several effective agents, usually a calcium channel blocker like Verapamil is the first choice, other options are corticosteroids or lithium. So since preventing is as much if not more important then the episodic treatment I think you should talk to your doctor about getting a prescription about this prophylactic treatment.
I hope you will get better soon.
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What Causes Cluster Headaches?

I read your query and I am sorry about what you are going through. Regarding your question of whether it s normal of feeling tired and run down I would say that it is normal considering it has been for more than two weeks for every night. On whether other diagnoses have been checked, while what you describe fits with cluster headache, you don t mention much about the headache itself, localization, onset and how long each episode, frequency of episodes, accompanying symptoms (tearing, eyelid swelling, stuffed nose etc), so I can t say for sure whether all criteria for cluster headache are fulfilled. I do have suggestions to make about treatment though. It seems you get only treatment to abort the painful episode, but usually preventive treatment is employed as well which is more important. It should be started when a cycle begins and continued until you are headache free for at least 2 weeks, after that it is tapered slowly. There are several effective agents, usually a calcium channel blocker like Verapamil is the first choice, other options are corticosteroids or lithium. So since preventing is as much if not more important then the episodic treatment I think you should talk to your doctor about getting a prescription about this prophylactic treatment. I hope you will get better soon.