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  • Michael DeBrincat B.Pharm. (Hons.) MSc. Community

'Suicide' headaches (Cluster)


Cluster headaches also known as 'suicide' headaches due to the extreme pain they may cause are considered the most painful of all headaches.

Pain is limited to one side of the head around the eye and sometimes extends to the back of the head.

Other symptoms include agitation or restlessness (pace or sit and rock back and forth, red eye, eyelid swelling, forehead and facial sweating, tearing, nasal congestion, runny nose and drooping eyelid. The above symptoms can also be seen in migraine sufferers but occur less frequently then in cluster headaches.

Risk factors include:

Gender: Men are more likely to have cluster headaches.

Age: Most people who develop cluster headaches are between ages 20-50, although the condition can develop at any age.

Smoking: many people who get cluster headache attacks are smokers. However, quitting smoking usually has no effect on the headaches.

Alcohol use: alcohol can trigger an attack if you are at risk of cluster headache.

A family history: having a parent or sibling who has had cluster headache might increase your risk.

The headache attacks occur in cycles or bouts lasting weeks or months, often referred to as a cluster attack period. This is usually followed by remission periods when the headaches stop. During remission, no headaches occur for months and sometimes even years.

These attack periods are often more severe with changes in daylight hours, most notably around the start and end of daylight saving time.

During a cluster period:

  • Headaches usually occur every day, sometimes several times a day.

  • A single attack can last from 15 minutes to 3 hours.

  • The attacks often occur at the same time each day.

  • Most attacks occur at night, usually one to two hours after you go to bed.

The pain usually ends as suddenly as it began, with rapidly decreasing intensity. After attacks, most people are pain-free, but exhausted.

Treatment of cluster headaches

1. Termination therapy- aims is to quickly terminate an attack

2. Preventive therapy - aims to shorten the number and severity of attacks

3. Bridge therapy - aims to decrease pain until preventive therapy starts to work. Used for a short period of time (a few weeks).

When to see a doctor

See your doctor if you have just started to have cluster headaches to rule out other disorders and to find the most effective treatment.

Additionally if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.


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