Cluster Headache

Cluster headache treatment options have expanded with CGRP-targeted and device-based therapies. The session covers galcanezumab in episodic cluster (the first FDA-approved preventive), eptinezumab in cluster head-to-head data, sphenopalatine ganglion stimulation (Pulsante implant), non-invasive vagus nerve stimulation (gammaCore), oxygen therapy optimisation, lithium prophylaxis with monitoring, and verapamil dosing strategies. Discussion addresses cluster-headache pathophysiology and hypothalamic involvement, chronic vs episodic cluster differentiation, suicide-risk awareness in cluster patients ('suicide headache'), pediatric cluster (rare but documented), psilocybin for cluster headache evidence, and emerging targets including PACAP-38 antagonists.