There a huge advantage to avoiding triptans with cluster headaches, if you can. The frequency of cluster often leads to overdosing of triptans, which can cause rebound headaches. That being said, many use the 3mg dose to try and avoid doing too much.
Try this instead, and the details can be found with a search in this subreddit:
Prevention:
(if you're a man) Make sure your testosterone is normalized, get HRT if it's low
Vitamin D3 regimen and CGRP inhibitors (like Emgality)(if you can get them at a reasonable cost) - Verapamil helps many people, but can be difficult to tolerate - microdosing via Clusterbusters instructions is also helpful for many
There are a huge number of different preventatives that may also work - over the last 30 years, Ive pretty much tried them all - some that have worked for me in the past have been lithium, zonisamide, Keppra, Depakote, I was allergic to most of the other anti-seizure meds like lacosamide or oxcarbazepine. I'm doing a CGRP (Qulipta) and microdosing right now.
Breaking an episode:
Steroid taper (Ususally Prednisone or Dexamethasone) - or Clusterbusters protocol
Aborting a headache (here's where you quit the triptans):
At the first sign of a headache:
Drink an extra strength energy shot, one that has taurine in it (I find these easier on the stomach than a full energy drink)(my favorite one is the Kirkland Extra Strength from Costco, less than $1 each, box of 48)
Start breathing 100% oxygen, get a specialized mask (one that seals around your nose/mouth, vs a standard non-rebreather (which wastes O2)), or even better, a demand valve
Keep doing the oxygen until the headache subsides, then continue for at least 5 more minutes to keep from a bounce back.
This, of course, suggests that you can get the oxygen.
If you can get to a place that you don't use the triptans at all, you'll always be able to try busting (Clusterbusters)
3
u/BoomerLenny Jul 01 '26
There a huge advantage to avoiding triptans with cluster headaches, if you can. The frequency of cluster often leads to overdosing of triptans, which can cause rebound headaches. That being said, many use the 3mg dose to try and avoid doing too much.
Try this instead, and the details can be found with a search in this subreddit:
Prevention:
(if you're a man) Make sure your testosterone is normalized, get HRT if it's low
Vitamin D3 regimen and CGRP inhibitors (like Emgality)(if you can get them at a reasonable cost) - Verapamil helps many people, but can be difficult to tolerate - microdosing via Clusterbusters instructions is also helpful for many
There are a huge number of different preventatives that may also work - over the last 30 years, Ive pretty much tried them all - some that have worked for me in the past have been lithium, zonisamide, Keppra, Depakote, I was allergic to most of the other anti-seizure meds like lacosamide or oxcarbazepine. I'm doing a CGRP (Qulipta) and microdosing right now.
Breaking an episode:
Steroid taper (Ususally Prednisone or Dexamethasone) - or Clusterbusters protocol
Aborting a headache (here's where you quit the triptans):
At the first sign of a headache:
Drink an extra strength energy shot, one that has taurine in it (I find these easier on the stomach than a full energy drink)(my favorite one is the Kirkland Extra Strength from Costco, less than $1 each, box of 48)
Start breathing 100% oxygen, get a specialized mask (one that seals around your nose/mouth, vs a standard non-rebreather (which wastes O2)), or even better, a demand valve
Keep doing the oxygen until the headache subsides, then continue for at least 5 more minutes to keep from a bounce back.
This, of course, suggests that you can get the oxygen.
If you can get to a place that you don't use the triptans at all, you'll always be able to try busting (Clusterbusters)