Adopting the methods to prevent cluster headaches can be a great boon for the cluster headache sufferer because of the severe intensity of head pain that ruins his quality of life. 

There are several medicines available for preventing cluster headaches and you should leave it to your doctor to choose them, but these prophylactic medicines benefit you by lowering the frequency and duration of the symptoms, and in many cases preventing cluster headaches episodes.      

These preventive medicines for cluster headaches are used every day until the anticipated cluster period ends and then are tapered off where necessary.

Self-help

Cluster headaches onset due to exposure to the causes and trigger factors. One way to start prevention is to avoid this exposure However, no medicine completely prevents a cluster headache.

Certain lifestyle improvements such as avoiding smoking and alcohol, getting regular exercise and proper sleep, avoiding stressful situations, and certain foods like aged cheese, eggs, chocolates, and processed meats will help even otherwise.

Do keep a cluster diary, which will help identify the time of the day and season of the year when you most likely get these headaches and their duration. Using preventive therapy at these times will help.

Drugs to prevent cluster headaches

The following drugs are used in the prevention of cluster headaches and have proved helpful.

Calcium channel blockers

Verapamil, a calcium channel-blocking agent is the first line of treatment to prevent cluster headaches. It is required to be used on a long-term basis and helps to reduce the frequency of cluster headaches. It helps in the prevention of both episodic and chronic forms of cluster headaches.

Lithium carbonate

Lithium carbonate has been found to be useful in preventing chronic cluster headaches by its action on the biological clock which is believed by experts to be linked to causing these headaches.

Side effects include excessive urination, tremors, and diarrhea. Minimum dosages are advised as this drug can cause kidney damage. The drug is stopped by tapering the doses to avoid side effects.

Corticosteroids

Corticosteroids such as prednisolone and methylprednisolone are used short-term because of their fast action.

They are particularly advised if the cluster headaches are of recent onset or if the cyclical pattern is of short cluster periods followed by long remission periods.

Long-term use of steroids is not advised because of their potential side effects such as glaucoma, cataract, high blood pressure, diabetes, GERD, obesity, osteoporosis, and more.

Antiseizure drugs

Anticonvulsants or antiseizure drugs such as topiramate and valproic acid may be tried when other medications have failed.

Patients who take these drugs should be regularly watched and talked to as they can cause suicidal tendencies more so with the already existence of cluster (suicide) headaches.

Methysergide

Methysergide is an ergot alkaloid, which is taken for the prevention of cluster headaches rather than treating them.

It acts by constricting the blood vessels and should be taken for the short cluster period only because of its potential side effects of causing thickening of the heart valves and of the lining of the lungs and abdomen.

Starting and stopping this drug should be only on your doctor’s advice because it has to be stopped over tapering doses.

Melatonin

Melatonin in doses of 10 mg is seen to reduce the frequency of cluster headaches thereby helping prevention of cluster headache periods.

Surgery for cluster headaches

Rarely, surgery is advised when the patients cannot tolerate the headaches and medicines have failed to give relief.

This surgery involves deadening the pain-sensitive cells of the trigeminal nerve (5th cranial nerve), which also innervates the area behind and around the eye. This helps in the prevention of cluster headaches.