Posted by Jim R on November 02, 2001 at 06:48:00:
In Reply to: Lithium for Clusters posted by Nancy, wife of sufferer on November 02, 2001 at 06:11:26:
lithium is the "drug of choice", particularly for chronics but also for episodics. Here's a excerpt from the Medline drug listings:
Category
Antidepressant therapy adjunct
Antimanic
Granulopoietic
Vascular headache prophylactic
And from the article on this site:
Lithium
The discovery by Ekbom (1974a,b) of the effectiveness of lithium for the prophylaxis of cluster headache has had a major impact on the treatment of this condition. Many studies have now been published regarding the use of this agent and have been reviewed by both Ekbom (1981, 1986) and Manzoni et al (1983a). The dosage has varied from 300 to 1500 mg daily, averaging 600 to 900 mg/day. Kudrow (1980) has found that about 10 percent of patients require only 300 mg/day. Favorable responses occur within 2 weeks of commencing treatment, usually within the first week. The chronic form of cluster is particularly well-suited for lithium treatment, with about 80 percent of patients substantially improved and remaining so for substantial periods of time (Table 6-4). During successful lithium therapy, about 60 percent of patients experience bursts of short cluster periods that are generally mild and of short duration. Ergotamine added to lithium at dosages of 2 to 4 mg/day is a highly effective strategy, even when either drug alone has been ineffective (Stagliano and Gallagher, 1983). In Kudrow's (1980) experience, approximately 40 percent of his patients treated with lithium require such concomitant ergotamine prophylaxis for complete relief of headache.
In Ekbom's (1981) experience and in ours, lithium therapy blocks alcohol-provoked attacks in most patients with the chronic form of cluster. Following the cessation of lithium therapy, about 20 percent of patients experience long periods of remission, their disorder having transformed to the episodic form (Kudrow, 1980), which raises the possibility that lithium may alter the natural course of the disorder.