Acute treatments for clusters using sumatriptan, zolmitriptan, and oxygen are most common while prophylactic therapy may involve suboccipital steroid injection, verapamil, lithium, melatonin, warfarin, or prednisone.
Paroxysmal hemicranias and hemicranias continua (headaches that may last several months (with fluctuation) differ from cluster headaches in their response to indomethacin, a nonsteroidal anti-inflammatory drug (NSAID). When other diagnostics are similar to cluster headache syndrome except for a patient’s reaction to indomethacin, that – along with duration/frequency of the pain – may help confirm the diagnosis. Topiramate and gabapentin may also work for hemicranias continua, in particular, if the patient cannot tolerate NSAIDs.
Indomethacin is worth a trial in patients with side-locked headaches,