Headaches: Cluster - Surgery

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• Gastrointestinal problems (such as nausea, vomiting, and heartburn)
• Visual disturbances
• Ringing in the ear
• Hair loss
• Weight changes (weight gain is a significant problem with valproate, while weight loss occurs with topiramate)
• Agitation
• Odd movements
• In women, menstrual irregularities and a higher risk for polycystic ovary syndrome (PCOS)

Very serious side effects are rare but include the following:

• Liver damage
• Convulsions
• Coma
• Pancreatitis (inflammation of pancreas) in adults and children
• Significant increase in risk for birth defects in pregnant women

Investigational Drugs

Botulinum. Botulinum toxin A (Botox) injections are typically used to smooth wrinkles. Botox is also being studied for treatment of headaches, including the prevention of cluster headaches. Research is still preliminary, and there is not sufficient evidence to support its efficacy.

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Melatonin. Small reports indicate that melatonin, a brain hormone that helps to regulate the sleep-wake cycle, may help prevent episodic or chronic cluster headaches. Melatonin supplements are sold in health food stores, but as with most natural remedies, the quality of different preparations varies, and they have not been rigorously tested for safety or effectiveness. More studies are needed.

Review Date: 09/29/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).