Treatment of cluster headache.

Management of cluster headache has greatly changed in recent years although most of the drugs used have not received approval for this indications. Su bcutaneous injections of sumatriptan has been found to be remarkable effect ive for acute episodes. This drug continues to exhibit efficacy for long pe riods of use up to several months and has no serious adverse effects if use d according to recommendations. Nasal administration of oxygen (not approve d for this indication in France) continues to be an adjuvant treatment for patients with a contraindication for sumatriptan or for those with more tha n two acute episodes per day. Other treatments are under debate. Prophylact ic first intention verapamil (not approved in France for this indication) c ould be useful. Lithium (not approved in France for this indication) could also be helpful, particularly for certain clinical forms. Other options are discussed.