Friday, June 15, 2012

Prednisone and the treatment of cluster headaches

At one time or another, people get headaches. About 90% are caused by tension. They are an annoyance and pass away quite quickly. For the record, the brain tissue itself does not feel pain. When you have a headache, the problem lies in the tissues surrounding the brain and in the muscles and blood vessels in the face and neck. The remaining 10% of headaches are either migraines or the less common and most painful cluster headaches which seem to be caused by a disruption in the hypothalamus. This is only about 1% of the headaches experienced. The name comes from the frequency with which the occur. This can be episodic or chronic where attacks occur regularly more than once a month for more than one year.

When the pain strikes, it lives up to the nickname "suicide headaches". Coming without warning, the pain becomes severe within fifteen minutes, usually centering on the face around the eyes. People who suffer regular attacks have a higher suicide rate. Unfortunately, this form of headache seems to run in families, but can also be triggered by head injuries, sleep disorders, high altitude and bright light. The first treatment response is to give oxygen and one of the triptan sulfa drugs used for headaches. The long-term preventive treatment relies on a calcium-channel blocker drug but it takes two to three weeks to become effective in the body. To bridge between the emergency and long-term treatment, Prednisone is used to stabilize the patient.

Because this use is only for a short period, the risk of dependence is very small. Once the blocker drug takes effect, the Prednisone can be withdrawn. Should the headaches persist, it may be necessary to switch to other long-term drugs - some doctors use antidepressants and anti-seizure drugs. Prednisone can again be used during the switch over but, because of the risk of dependence, the length of time and dosage must be carefully controlled. It would be unfortunate if the headaches were prevented but you ended up dependent on Prednisone.

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