First recognized in 1867, cluster headaches remain one of the most painful and frustrating headache syndromes. Their cause is unclear, and no treatment is fully effective. People with cluster headaches may go for more than a year without any attacks, and then suddenly the headaches appear and strike several times a day. Each headache lasts from 30 minutes to 2 hours and consists of very severe pain on one side of the head, generally in the region of the eye. These daily headaches continue for 4 to 8 weeks, and then disappear for another year or more. A more chronic, continuous form of cluster headaches can also occur.

Cluster headaches are different from migraine headaches (although they may possess some underlying similarities) and much more difficult to treat. During cluster headache episodes, rapid-acting treatments are used, including aerosolized ergotamine, pure oxygen, lidocaine nasal spray, and anesthetic inhalation. For prevention, drugs such as ergotamine, prednisone, methysergide, and lithium may reduce the severity and frequency of attacks.

Proposed Natural Treatments

Some evidence suggests that people with cluster headaches have lower than average levels of the hormone melatonin.1–4 In a double-blind, placebo-controlled study of 20 people with cluster headaches, use of melatonin (10 mg daily) for 14 days significantly reduced headache severity and/or frequency compared to placebo.5 About half the participants given melatonin responded well.

As noted above, inhalation of 100% oxygen is sometimes used to treat cluster headache attacks. In preliminary controlled trials, use of hyperbaric oxygen (oxygen under pressure) not only treated the headaches, but also helped prevent further attacks.6–8

Intravenous use of magnesium has shown promise for cluster headache relief.9,10 However, use of oral magnesium has not been evaluated.