Prednisone Still a Key Cluster Treatment

A new study out of Germany confirms that prednisone is still a key, though temporary, cluster headache treatment.

Prednisone is a corticosteroid which suppresses inflammation. It’s used for a number of conditions, including lupus, arthritis, and some skin conditions, such as psoriasis. And, of course, cluster headache.

Patients who are given prednisone don’t generally take it long-term, for a number of reasons. Commonly, it can lead to loss of bone density. But it also suppresses the immune system, which can cause more problems. So when a specialist gives you prednisone, you gradually taper off over time, and then gradually start on another medication, such as verapamil.

In the recent study in Germany, patients started on 100mg of prednisone for 5 days, gradually lowering the dose by 20mg every three days after that. They started with verapamil as well at 120mg a day, gradually upping the dosage to 360mg daily (120mg 3 times a day) after 19 days, and staying steady there. Patients on prednisone did have fewer attacks than those without it, as expected.

The patients taking prednisone didn’t experience more side effects than the placebo group (remember, both were suffering from cluster headaches and taking verapamil). However, the group on prednisone was more likely to report “palpitations”.

Read more here in the Lancet: Safety and efficacy of prednisone versus placebo in short-term prevention of episodic cluster headache

Prednisone has long been recommended for cluster treatment, and many patients have found it to work extremely well. There can be a bit of a rebound after going off the medication. And, of course, it’s only a temporary solution. We continue to hope that better, longer lasting treatments will be found.