I've tried these, originally for CH but also for migraine, with very different results.

For CH, they can work, but take about 15 or so minutes to take effect, which is a long time for a CH, especially when oxygen or imitrex injections will kill the CH in about 5 minutes.

But for migraine it's a different story. Whilst it still takes about 15 minutes, this is a LOT more tolerable and it seems to kill the migraine for me. However you need to not take them too often as you can get rebounds from them.

It seems that most doctors who proscribe them just assume that as they work for migraine they will work fine for CH when there are much better alternatives for CH.

There are seveal meds in this family which differ in speed and duration of action. This allows a particular med to be matched to the quality of your attacks--speed of onset, duration, etc.

In general, sumatriptan injection (Imitrex) is med of choice for Cluster because of its rapid action and hard punch to knock down a Cluster attack.

Which one to use is a decision to be worked out with your doc; not an issue of "best" for that is controlled by your response.

Print out the PDF file, below, and use as a tool to discuss your options with the doc.