<unk>  headache treatment is generally divided into acute therapy or abortive therapy focused at aborting individual attacks and preventive or prophylactic therapy aimed at preventing recurrent attacks during the<unk>  period.<unk>  headaches often go undiagnosed for many years, being confused with migraine or other causes of headache. Because of the relative rareness of the condition and ambiguity of the symptoms, some sufferers may not receive treatment in the emergency room and patients may even be mistaken as exhibiting drug-seeking behavior. Over-the-counter pain medications (such as aspirin, paracetamol, and ibuprofen) typically have no effect on the pain from a<unk>  headache. Unlike other headaches such as migraines and tension headaches,<unk>  headaches do not respond to biofeedback. Some have reported partial relief from narcotic pain killers. Percocet (Oxycodone with paracetamol) has had widespread success amongst some<unk>  headache patients, especially males. Anecdotal evidence indicates that<unk>  headaches can be so excruciating that even morphine does little to ease the pain. However, some newer medications like fentanyl (and Percocet) have shown promise in early studies and use.
During the onset of a<unk>  headache, the most rapid abortive treatment is the inhalation of pure oxygen.
Alternative first-line treatment is subcutaneous administration of triptan drugs, like sumatriptan and zolmitriptan.
Because of the rapid onset of an attack, the triptan drugs are usually taken by subcutaneous injection rather than by mouth.
Lidocaine and other topical anesthetics sprayed into the nasal cavity may relieve or stop the pain,  but long term use is not suggested due to the side effects and possible damage to the nasal cavities.
Previously, vaso-constrictors such as ergot compounds were also used, and sufferers report a similar relief by taking strong cups of coffee immediately at the onset of an attack.
Ergotamine is available as a 2 mg sublingual tablet.
The initial dose is 2 mg and may be repeated every 30 minutes with a maximum dose of 6 mg daily and 10 mg a week.
Intranasal Dihydroergotamine (DHE) may also be effective for<unk>  headache.
DHE is given as a 1 mg intravenous bolus and may be repeated at one hour, with a maximum dose of 3 mg in 24 hours.
Lying in a dark room may be helpful for symptoms of  Horner's Syndrome.
Cool showers
Vigorous exercise, due to an increase in adrenaline and changes in blood pressure.
Sexual intercourse and  orgasm may terminate an attack possibly by acutely modulating hypothalamic function.
A wide variety of prophylactic medicines are in use, and patient response to these is highly variable.
Current European guidelines suggest the use of the calcium channel blocker verapamil at a dose of at least 240 mg daily.
Steroids, such as prednisolone, are also effective, with a high dose given for the first five days before tapering down.
Methysergide, lithium and the anticonvulsant topiramate are recommended as alternative treatments.
Muscle relaxants and atypical anti-psychotics have also been used.
Magnesium supplements have been shown to be of some benefit in about 40% of patients.
Melatonin has also been reported to help some.
There is substantial anecdotal evidence that serotonergic psychedelics such as psilocybin (mushrooms) and LSD and LSA d-Lysergic acid amide(Rivea corymbosa  seeds) abort<unk>  periods and extend remission periods.
Cluster headache medical therapy
Tension headache medical therapy
Migraine medical therapy
Benign paroxysmal positional vertigo interventions
Dizziness medical therapy
Tension headache prevention
Otalgia medical therapy
Headache medical therapy