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Naratriptan in the Prophylaxis of Cluster Headache
E. Loder
Posted December 2002  
Headache 2002;42:56-57

A 36-year-old man with cluster headache refractory to trials of standard prophylactic treatment, and only partially responsive to parenteral sumatriptan and inhaled oxygen, was admitted to an inpatient pain unit. The diagnosis of cluster headache was confirmed by direct observation of a typical attack.

Despite efforts at prophylaxis, the patient continued to experience 3 to 4 severe headaches per day. Attempts to control his headaches with scheduled parenteral dihydroergotamine (DHE) were successful, but headaches recurred when the medication was tapered, and continuous or intermittent use of parenteral DHE was not felt to be a practical option for the patient.

Naratriptan 2.5 mg twice daily completely abolished his headaches, which recurred when the medication was discontinued. No EKG or laboratory abnormalities were observed during treatment, and the patient reported to side effects.