Melatonin as Adjunctive Therapy in the Prophylaxis of Cluster Headache: A Pilot Study

Abstract

Patients with chronic cluster headache or patients with episodic cluster headache whose headaches are uncontrolled on conventional therapy do not appear to gain therapeutically from the addition of melatonin to their usual treatment regimens. It is perhaps the phase-shifting properties of melatonin that mediate its effect in patients with episodic cluster headache, and it may be necessary to treat from the beginning of the cluster bout to reset the circadian pacemaker, thus producing a more positive outcome.

Chronic cluster headache: a review

“…In a double blind, placebo-controlled trial in 18 ECH and 2 PCCH patients, melatonin appeared only effective in the prophylaxis of ECH [33]. In another study, in 6 CCH patients and 3 ECH patients who did not react to conventional therapy, there was no effect of melatonin [34]. The lack of response in CCH may reflect a fundamental difference between the chronic and episodic condition.…”

Ramelteon in the Prophylaxis of Chronic Cluster Headache- Case Report

“…This trial reported a significant decrease in CH attacks in the melatonin-treatment group when compared with the placebo group [4] . However, a more recent doubleblind, placebo-controlled trial using melatonin treatment for CH did not report a significant difference in attacks [7] . Therefore, response to melatonin treatment for CCH differs between reports [8,9] .…”

Melatonin 4 mg as prophylactic therapy for primary headaches: a pilot study

“…In a randomized, double-blind, placebo-controlled trial, sleep quality assessed using the Pittsburgh Sleep Quality Index did not improve during melatonin treatment in migrai neurs (Alstadhaug et al, 2010). Serum melatonin levels are reduced in patients with cluster headache, particularly during a cluster period (Pringsheim et al, 2002). As regards plasma melatonin levels in migraine, the limited published data available derive from three small studies, the results of which suggested that female migraine sufferers have decreased nocturnal plasma melatonin levels both overall and during migraine attacks (Claustrat et al, 1989;Brun et al, 1995;Murialdo et al, 1994).…”