What is the role of steroids in treating cluster headaches?

Steroids play a significant role in the short-term acute relief of cluster headaches. These headaches are characterized by their severe, debilitating nature, often occurring in cyclical patterns or "clusters." When a cluster headache attack occurs, the goal is to provide rapid and effective relief from the intense pain.

Corticosteroids, such as dexamethasone, can be utilized during these acute episodes, especially when a rapid response is required to bring down inflammation and alleviate symptoms. They are effective in aborting the attack or reducing the frequency and severity during a cluster period. The use of steroids is beneficial because they can act quickly to disrupt the inflammatory processes associated with the headache.

In contrast to steroids’ role in treatment, other options like long-term pain relief directly are not typically achieved with steroids; they rather serve for a brief period. Preventive maintenance therapy usually involves other medications, such as verapamil or other preventive drugs, which help in managing the frequency of attacks over the long term rather than during acute phases. Lastly, while they may be considered in certain cases, steroids are not commonly used as adjunctive therapy to narcotics in the management of headaches.