Table 13 Acute therapies used in cluster headache by specialists

Triptans:

None can be recommended for use more than twice a day

 • Sumatriptan 6 mg s/c

 • The most highly-effective acute treatment

 • Zolmitriptan 5 mg nasal spray

 • Less-certain efficacy but an alternative for those unable or unwilling to use sumatriptan s/c

 • Sumatriptan 20 mg nasal spray

 • Less-certain efficacy: absorption depends largely on ingestion

Oxygen 100% at ≥12 l/min until response, or for ≥15 min

• Requires a non-rebreathing mask and regulator;

• Helps some people and may be used as frequently as needed