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This is false as people who suffer from cluster headaches have been known to commit suicide to stop the intense pain. Therefore, a cluster headache attack could be considered life threatening as it could cause a reasonable person to commit suicide that otherwise would have not ended their life if they did not suffer from such a condition. Source: http://umm.edu/health/medical/reports/articles/headaches-cluster Quote: More than half (55%) of respondents reported experiencing suicidal thoughts. — Preceding unsigned comment added by 173.95.181.125 ( talk) 08:16, 29 November 2013 (UTC)
Then this should be clearly noted. People use Wikipedia as a first-line medical source whether or not that is right, and this is absolutely a relevant and somewhat unique feature of this disease, wherever the information is put categorically.
Please review WP:MEDRS and WP:MEDMOS, including WP:MEDMOS#Sections. Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches helps understand how to apply Wikipedia's medical sourcing guidelines, and where/how to find secondary review sources. SandyGeorgia ( Talk) 17:54, 2 January 2014 (UTC)
This article is rife with primary studies: see WP:UNDUE, WP:RECENTISM, WP:NOT (news or a support forum), and WP:MEDRS. I've removed this text for discussion. SandyGeorgia ( Talk) 19:23, 2 January 2014 (UTC)
In 2012-2013, in an effort to reduce the amount of imaging, number of consults and number of admissions related to headache whilst maintaining pain relief for patients, pain physicians from the Cleveland clinic are working to refine an algorithm for use in Emergency Department (ED) headache presentations. Details of a report on implementation of the algorithm were presented at the 2013 International Headache Congress and showed an 82% reduction in the use of opioids in Headache presentations in ED. “We were astonished at how much we were able to diminish the use of opiates,” - lead investigator Cynthia Bamford, MD. Further validation of the algorithm will show whether it will hold up in various ED settings. [1] [2]
Some of the sourcing in this article is extremely poor. This is a marginal review (appears to be only a partial review combined with a study on a small sample); nonetheless,
{{
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help); Cite has empty unknown parameter: |1=
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(
help)mentions "suicide" headache. SandyGeorgia ( Talk) 19:52, 2 January 2014 (UTC)
“ | The severity of the pain has earned it the sobriquet “suicide headache,” although in our experience this is a rare occurrence in this exceptional patient group. | ” |
This needs to be more explicitly stated in the article, that the pain of cluster headaches can and DOES lead to suicide attempts and completion among sufferers. I have tried to get this put in the article multiple times and despite including sources-- *good* sources and sometimes upwards of five or six for two sentences-- it never sticks. Why, I really don't know, and once again I must stress I feel that this is of utmost importance. I have a couple more sources than just the ones mentioned here but the aforementioned study is indeed the largest that discusses it. The psychological component of this disease is a huge part of management and prognosis, especially with regards to self-harm and suicide, and it's barely even mentioned in the article. I don't have an account so I'm not sure how to sign this. Guest?
^^Great, at least that's something. I went in and fixed two minor typos in the sentence you inserted but it still reads exactly the same. Is there a better place (or any place at all) to attach some of the sources I have on this issue besides the article itself? I may have lost access to some of them as a result of no longer having full(er) access to JSTOR or PubMed-- just can't remember where they all came from-- but I'm fairly certain that I still have at least a few that discuss this. In fact, the largest study that examined this problem at least partially isn't even the one currently cited in the article. It was mentioned above, "Rozen, T., MD, and Fishman, R. "Cluster Headache in the United States of America: Demographics, Clinical Characteristics, Triggers, Suicidality, and Personal Burden," published in Headache in 2011." [3] There are others, so let me know what I can do. (Same guest as above)
This article says the same things over and over and over, often based on primary sources, looking like individual researchers wanted to work their links in. I'm reducing some of the redundant prose, but by no means all of it; that should be done better when the article is thoroughly rewritten to reflect more recent secondary reviews-- since the article is so poorly sourced, it's hardly worth it at this stage to clean up all the prose. SandyGeorgia ( Talk) 21:52, 2 January 2014 (UTC)
There are 2 cochrane reviews, one is already used, here is the other: [3]. Lesion ( talk) 23:07, 2 January 2014 (UTC)
I would really like to improve the discussion that is there now, but I want to do it right. Maybe you can advise me. My concerns relate to these two elements: 1. Vasoconstrictors such as ergot compounds are sometimes used immediately at onset of attack. Cafergot, a vasoconstrictor combination of caffeine and ergot, has been demonstrated in some cases to abort cluster headaches within 40 minutes of ingestion. BOL (2-bromo lysergic acid diethylamide), a non-psychedelic form of the ergot-derived psychedelic LSD, has shown promise in the treatment of cluster headaches.[unreliable medical source?][48] 2. Some isolated case reports suggest that ingesting LSD, psilocybin or cannabis can reduce cluster headache pain and interrupt cluster headache cycles.[49]
Re #1, there really is no relationship between cafergot and BOL-148, except that they both contain ergots (as do some other CH meds mentioned elsewhere in the article). So, I would make a new topic. Re BOL-148, I can edit to provide a link to a peer-reviewed journal, Cephalagia, which published the results of a small trial of BOL-148 for people with CH. But I think that's a "primary source." Would it allow for removing the "unreliable medical source" note that there's now (deservedly so)? BOL-148 is different from cafergot, among other things because it seems to be not just an abortive (and not just an generally ineffectual abortive, as cafergot is) but also a possible preventive. For people with CH, the difference between maybe aborting an attack in 40 minutes and preventing attacks altogether is enormous.
And the fact that BOL-148 works is evidence that the next part -- about LSD, etc. -- is not some whackjobs taking drugs to escape their pain. BOL-148 works because it has LSD in it. So, Re #2. I don't know what "some isolated care reports" means. As far as I know, there is exactly one report of cannabis helping someone, whereas research conducted by medical professionals has shown hundreds of cases in which CH patients receive relief from psilocybin, LSA, and LSA. Yes, these are anecdotal self-reports collected by those medical professionals, and not clinical trials, but since the substances are scheduled, there's no more than that that can be done. I could cite several such reports (and I note that LSA, which is not mentioned in the current text, is the subject of some of them), but again I fear that this will be removed as "primary sources."
There are probably thousands of CH sufferers using LSA, LSD, and psilocybin to treat CH, with no lasting side effects (LSA, for that matter, is effective even without short-term psychedelic "side effects"). I understand someone's reluctance to give this treatment what I think of as its proper attention here -- it's not medically proven; it might sound weird or scary to some people; and the substances are scheduled. At the same time, it is saving lives every day.
If you're going to delete any edits I make, I guess I just won't bother doing so. But if there's a way to provide this information that is consistent with Wikipedia's policies, I would be happy to take a shot at it.~~chfather~~ — Preceding unsigned comment added by Chfather ( talk • contribs) 00:34, 3 January 2014 (UTC)
Another factor in writing for Wikipedia is that Wikipedia text must be verifiable to and rely on secondary sources; we can't engage in original research by analyzing or reporting on primary research studies that haven't been reviewed by secondary sources (that is, independent from the researchers who did the studies)-- our medical sourcing guidelines prefer secondary reviews to primary studies. Primary studies are individual case reports, trials, studies whether controlled or not, animal studies, surveys, and other studies that-- even if published in peer-reviewed journals-- haven't been the subject of a secondary review from independent authors examining their conclusions.
In addition to that, there are a lot of things that Wikipedia is not-- we aren't news, we aren't recent, we aren't for support-- a whole lot of things. We should only be reporting and giving due weight to what other secondary sources have already stated, in encyclopedic tone. An encyclopedia doesn't strive to be current in the same way the daily news does; it strives for long-term accuracy.
To that end, I have gone through and flagged numerous primary sources and laypress reports that don't meet our sourcing requirements, shouldn't have been in the article, and need to be replaced with secondary reviews. I've also removed some text that simply shouldn't be here at all without secondary sources (treatment issues, etc), and flagged the secondary reviews now (correctly) in the article by adding the word "Review" to their citations.
On the topic of psilo/LSD, there is mention of it in one secondary review ( PMID 21352222), and that is in the article now; unless that review has more to say on the topic, or unless other secondary reviews surface, it won't be productive for you to write from laypress or primary sources on the topic of psilo/LSD.
This article was (is) actually in pretty bad shape, making use of very old sources, including a lot of repetitive text and editorializing; I've only made a first pass at cleanup, and some other editors will probably go through soon and try to beef it up. It will benefit everyone for the article to be as good as it can be, as it's not close now!
If you want to know more about how to research for writing medical content on Wikipedia, Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches explains how to locate secondary reviews in PubMed. Regards, SandyGeorgia ( Talk) 03:50, 3 January 2014 (UTC)
Apologies if I'm not putting this in the correct place. I'm just learning method and policy for editing wikipedia. The Dr's Sewell, Halpern and Pope study was cited before someone deleted it. When it was added back the citations didn't come back. As a separate question regarding wikipedia policy: Is there a way to have a separate Cluster Headache article that isn't in the medical documentation category, and therefore information that's not peer reviewed could be added (by primary study instead of secondary?). It seems some life saving information could easily be left out that a sufferer could find life saving. Ie, how sufferers use O2 to stop individual attacks quicker (that doctors don't even know, nor would any study ever be created with secondary review as there are many different ways to use O2. Some ways are nearly useless, like just breathing normally. Many doctors don't even write the scripts correctly for non rebreather mask, LPM etc. Sorry don't mean to be too wordy. Just trying to figure out how to get important (but not peer reviewed) information available to those that find Wikipedia in their online search. Thanks in advance, Jeff — Preceding unsigned comment added by 75.115.201.35 ( talk) 18:50, 6 January 2014 (UTC)
Whether cited to Sewell or not, Sewell is a primary source; we need secondary reviews of it, and on the reading I've done in the last few days (I am not fully caught up yet, still getting the sources and reading through them), we do not have a good review of that study, raising due weight issues.
As to a separate article that is not "medical", it is not the article that matters, it's the content. Medical and health-related content anywhere on Wikipedia needs to meet medical sourcing guidelines. I understand your concern, but it is not Wikipedia's role to advocate, rather to state what secondary sources have already stated in reliable sources. SandyGeorgia ( Talk) 18:57, 6 January 2014 (UTC)
SandyGeorgia, Thanks for the tildes info I was just coming back to add to my post when I saw the responses. Appreciate everyone's patience. AndyTheGrump, I definitely understand the reason and need for primary studies in regards to medical information. No one would want any old yahoo putting any cure they found themselves in Wikipedia (I've seen some crazy and useless "cures" people come up with and completely agree with you). On the other hand the only reason there aren't secondary studies on Psylo is because most Dr's don't want to risk their medical license or medical standing by discussing something that's not legal in most places. On the other hand the back door treatment for many with Cluster Headaches (that aren't treatable by "Dr Approved" methods) really works significantly better (per primary study) than anything that's scriptable by the Docs. As an example the first line treatment most doctors prescribe is Verapamil (off label, because yes, it's not approved for CH treatment), but it's only approx 5% effective. I guess it's a catch 22 that psylo and LSD fall into with CH, which is why I'm fishing for alternative ways to provide the information in a Wikipedia approved manner (referencing the few medical studies on it's effectiveness). Another example; cutting on someone's brain is barbaric (but doctor approved) as compared to taking a small dose of a non Dr approved substance that in the majority of patients stops the attacks. Thanks for the feedback, Jeff 75.115.201.35 ( talk) 19:30, 6 January 2014 (UTC)
the degree to which psilocybin as a treatment for CH's is marginalized in this article is a travesty. — Preceding unsigned comment added by 104.163.140.61 ( talk) 14:51, 7 May 2022 (UTC)
We should remove all names of experts and researchers, and their quotes. Suggest only keep name of the person who discovered it (1974, Ekbom according to one source). Lesion ( talk) 04:24, 3 January 2014 (UTC)
Is cluster headache not alternately referred to as CH? Because switching many of the uses of the phrase cluster headache to CH in the article would probably shave 5KB !! SandyGeorgia ( Talk) 07:03, 3 January 2014 (UTC)
I noted that this article also uses "sufferer" in a few places. The MEDMOS discourages this, instead we should use more neutral wording like "persons with cluster headache". Lesion ( talk) 01:39, 4 January 2014 (UTC)
Done for now-- ready for another pass from Lesion or Jmh649 or Anthonyhcole. SandyGeorgia ( Talk) 16:02, 4 January 2014 (UTC)
I think that was the most dangerous stuff. We have inline tags so have removed the banners from the lead. Feel free to replace them if you feel strongly. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 12:06, 4 January 2014 (UTC)
Under "Prevention," the entry now states: >>The recommended first-line preventative therapy is verapamil, calcium channel blocker.[3][35] Despite its usefulness, only four percent of people with cluster headache report verapamil use.[5]<< I suppose that first sentence is supposed to say "a calcium channel blocker," but my concern is with the second sentence, which is using a 2005 report that was surely compiled in 2004 or earlier -- and although the specific 4% assertion is not cited in that report, it appears to come from even older sources, to judge from the nearby citations. The entry suggests that the 4 percent statistic is current, and there's no justification for that. I don't have more recent information, but the wording is nevertheless misleading. From anecdotal experience, I'd bet that verap is prescribed to at least 40-50 percent of diagnosed people in the US; how many continue using it, I wouldn't know. Chfather ( talk) 02:30, 6 January 2014 (UTC)
We have very good recent reviews on treatment, and we should be using them. I am not able to find that any of them give the weight to psilocybin that we give. PMID 20352587 is a comprehensive, 2010 review, and we have a Cochrane review on oxygen therapy, PMID 18646121, which we are under-using. SandyGeorgia ( Talk) 17:05, 6 January 2014 (UTC)
The use of NBOT in the termination of cluster headaches was supported only by weak evidence from 2 small randomized trials, but given the safety and ease of treatment, the use of NBOT will likely continue. There is insufficient evidence from randomized trials to establish whether HBOT is effective in the acute treatment of cluster headache. Lastly, there was no evidence to suggest that either NBOT or HBOT were effective in the prevention of either migraine or cluster headaches.
[ [4]]
63 people interviewed. The percentage of patients with pituitary abnormalities is interesting. Plus, whoever wrote this CH wiki needs to find sources for the hypothalamus/timetable point. This article should do it. If you wanna get the primary source, this neurologist from sweden has got it all written out for you, since I cant do it myself. So use it if ya wanna. It should be referenced. It makes the most logical sense that the reason the headaches occur in the first place would be associated with the hypothalamus. Ive had them for 4 years, every may for a month. 1 to 3 a day usually. Sometimes i get a day off, but im waiting for it to kick in again the whole time i dont have the CH. Needless to say, Im not looking forward to a month from now.
RossChapman311 (
talk)
06:01, 7 April 2014 (UTC)
"Valproate, sumatriptan and oxygen are not recommended as preventative measures" ref states "Based on current evidence, one review suggested that sumatriptan, valproate (Depacon), misoprostol (Cytotec), supplemental oxygen, cimetidine (Tagamet), and chlorpheniramine should not be used for preventive treatment" [5] Doc James ( talk · contribs · email) (if I write on your page reply on mine) 16:22, 8 October 2014 (UTC)
Some news regarding causes: Naegel S, Holle D, Desmarattes N, Theysohn N, Diener HC, Katsarava Z, Obermann M (2014). "Cortical plasticity in episodic and chronic cluster headache". Neuroimage Clin. 6: 415–23.
doi:
10.1016/j.nicl.2014.10.003.
PMID
25379455.{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) - Open access. --
Friedrich K. (
talk)
13:59, 9 November 2014 (UTC)
"In one study, daily capsaicin was applied in the nose achieved not only desensitization over the next few days to the local pain but also CH relief: "Those who rubbed capsaicin in the nostril on the opposite side of the head had nothing happen. They started out having around 40 attacks a day, and a month later the headaches were still going strong. Those that rubbed capsaicin in the nostril on the side of the head where the headaches were, cut the average number of attacks in half, and in fact half the patients were cured–the cluster headaches were gone completely. All in all, 80% responded, which is at least equal to if not better than all the current therapies out there," as reported by Michael Greger, M.D. and referencing a 2009 peer reviewed study. [4] [5]"
This ref [6] does not mention capsaicin? And this ref [7] is not good enough. Doc James ( talk · contribs · email) 20:59, 4 March 2016 (UTC)
Pain. 1994 Dec;59(3):321-5.
Preventative effect of repeated nasal applications of capsaicin in cluster headache. Fusco BM1, Marabini S, Maggi CA, Fiore G, Geppetti P. Author information Abstract
Preliminary studies have shown that repeated nasal applications of capsaicin prevented the occurrence of cluster headache attacks. The present study was designed to verify the difference in efficacy of treatment with nasal capsaicin, depending on the side of application. Fifty-two patients affected by episodic form were divided into 2 groups, one receiving the treatment on the same side where the attacks occurred (ipsilateral side), the other on the controlateral side. Eighteen patients with a chronic form alternately received both ipsilateral and controlateral treatments. Seventy percent of the episodic patients, treated on the ipsilateral side, showed a marked amelioration whereas no improvement was noted in the patients treated on the contralateral side. The efficacy of ipsilateral treatment was emphasized by the results obtained in chronic patients. However, in these patients, the maximum period of amelioration lasted no more than 40 days. The difference between the effects of the 2 treatments (contralateral and ipsilateral) was statistically significant in both episodic and chronic sufferers. The efficacy of repeated nasal applications of capsaicin in cluster headache is congruent with previous reports on the therapeutic effect of capsaicin in other pain syndromes (post-herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia) and supports the use of the drug to produce a selective analgesia. PMID: 7708405 [PubMed - indexed for MEDLINE]
Btw, this isn't place for discussion but sufferers --I am not one-- may be very interested in personal experiences e.g. Debra-Elaine Simpson's, Junior Hernandez's, TheHusky's at the top fo the comments of that youtube link. The pain level sounds just awful and my heart goes out to sufferers Harelx ( talk) 23:28, 4 March 2016 (UTC) Doc James, if you're ever looking to (also) volunteer at another site, have you seen wikidoc.org? [10] is their about page, started by a Harvard physician..starts off with wikipedia but has medical professionals like you on staff. I really like wikipedia (notwithstanding above) but that seems like a nice sister project, as far as health and medicine. Harelx ( talk) 23:37, 4 March 2016 (UTC)
Found a review here [12] which found the benefit unclear. Doc James ( talk · contribs · email) 06:54, 5 March 2016 (UTC)
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All of this should be edited or removed:
"The cause is unknown.[2] Risk factors include a history of exposure to tobacco smoke and a family history of the condition.[2] Things that may trigger attacks include alcohol, and nitroglycerin.[2] They are a primary headache disorder of the trigeminal autonomic cephalalgias type.[2] Diagnosis is based on symptom.[2]
Recommended management include lifestyle changes such as avoiding potential triggers.[2]"
The text cited is from a 2013 source, and there have since been publications since then describing causes. Also, starting a paragraph about "recommended management" about "lifestyle changes" is irresponsible, since cluster headaches can very rarely be avoided, even if triggers are avoided (need to cite source). — Preceding unsigned comment added by Oholleran ( talk • contribs) 17:59, 5 October 2017 (UTC)
References
Appears to be a very rare differential. As such IMO it is fine to simple go in the body of the article under differential and is not needed in the infobox. Doc James ( talk · contribs · email) 19:34, 7 December 2017 (UTC)
References
doi:10.1016/S1474-4422(17)30405-2 JFW | T@lk 15:32, 18 December 2017 (UTC)
The Journal of Neurology, Neurosurgery and Psychiatry has an interesting piece about how becoming sexually aroused can make a cluster headache go away. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077391/. Is this the only medical condition that can be "treated" by becoming sexually aroused? And does this raise ethical questions about whether health services could or should provide the means of becoming sexually aroused as a form of treatment? Matt Stan ( talk) 15:36, 26 April 2018 (UTC)
I need to sign up to some research project & volunteer my own findings. I've suffered from both migraine & cluster-headaches since childhood, & have a variety of coping strategies for each. lying still in a dark room isn't one of them. but I have found, that against the onset of a cluster-headache, several things help. coffee, marijuana, sugar, coca-cola, sex & bowel-evacuation. some combination of these activities generally helps. the pain of these headaches is not overstated here- I have described my fear to colleagues that one day, one of these headaches will strike while I am in the neighbourhood of my electric drill; trepanation &/or permanent sleep being the objective.
duncanrmi ( talk) 21:55, 9 April 2021 (UTC)
The FDA recently approved an electrical stimulation device (marketed under the name "gammaCore)" to be used to treat cluster headaches. I don't have the expertise to update the "Management" section, but I recommend that someone with the requisite knowledge do so. [A 2018 FDA memo may be a good place to start.] I am aware that other similar devices may become FDA-approved for cluster headache treatment within the next few years, so a new subsection on "electric stimulation devices" may be in order. — Preceding unsigned comment added by Drbb01 ( talk • contribs) 00:35, 19 January 2019 (UTC)
Ref does not make this claim. Doc James ( talk · contribs · email) 01:18, 30 January 2019 (UTC)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738593/ it is used in the body Walidou47 ( talk) 20:52, 6 April 2020 (UTC)
I do not think we need a separate section for one sentence. Doc James ( talk · contribs · email) 17:37, 7 April 2020 (UTC)
The 2006 study referenced in 'research direction' is not really suitable for this section as it's misleading. The study concluded in 2006 and showed significant results in both the management and prevention of CH. I'd therefore like to remove this particular sentence and place the findings of this study under the 'other' sections within prevention and management. Is there any objection to this suggestion? JulianParge ( talk) 16:00, 12 June 2020 (UTC)
What would be the best way to include ongoing research into what seems to be a remarkably effective treatment that has failed to gain much attention yet.
https://n.neurology.org/content/82/10_Supplement/P1.256
There is version/variant of the above protocol in a document "Suggested Headache Preventative Treatment Protocol" .... "prepared for neurologists, pain specialists, and primary care physicians who routinely treat patients with headaches."
Idyllic press ( talk) 10:37, 7 November 2022 (UTC)
Does Wikipedia even allow the content that's written here? All the statements have citations, but it sounds like it was written by a tobacco company. 184.176.138.209 ( talk) 07:36, 27 April 2023 (UTC)
This is the
talk page for discussing improvements to the
Cluster headache article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: 1 |
![]() | This article is rated C-class on Wikipedia's
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![]() | Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
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This is false as people who suffer from cluster headaches have been known to commit suicide to stop the intense pain. Therefore, a cluster headache attack could be considered life threatening as it could cause a reasonable person to commit suicide that otherwise would have not ended their life if they did not suffer from such a condition. Source: http://umm.edu/health/medical/reports/articles/headaches-cluster Quote: More than half (55%) of respondents reported experiencing suicidal thoughts. — Preceding unsigned comment added by 173.95.181.125 ( talk) 08:16, 29 November 2013 (UTC)
Then this should be clearly noted. People use Wikipedia as a first-line medical source whether or not that is right, and this is absolutely a relevant and somewhat unique feature of this disease, wherever the information is put categorically.
Please review WP:MEDRS and WP:MEDMOS, including WP:MEDMOS#Sections. Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches helps understand how to apply Wikipedia's medical sourcing guidelines, and where/how to find secondary review sources. SandyGeorgia ( Talk) 17:54, 2 January 2014 (UTC)
This article is rife with primary studies: see WP:UNDUE, WP:RECENTISM, WP:NOT (news or a support forum), and WP:MEDRS. I've removed this text for discussion. SandyGeorgia ( Talk) 19:23, 2 January 2014 (UTC)
In 2012-2013, in an effort to reduce the amount of imaging, number of consults and number of admissions related to headache whilst maintaining pain relief for patients, pain physicians from the Cleveland clinic are working to refine an algorithm for use in Emergency Department (ED) headache presentations. Details of a report on implementation of the algorithm were presented at the 2013 International Headache Congress and showed an 82% reduction in the use of opioids in Headache presentations in ED. “We were astonished at how much we were able to diminish the use of opiates,” - lead investigator Cynthia Bamford, MD. Further validation of the algorithm will show whether it will hold up in various ED settings. [1] [2]
Some of the sourcing in this article is extremely poor. This is a marginal review (appears to be only a partial review combined with a study on a small sample); nonetheless,
{{
cite journal}}
: Check |url=
value (
help); Cite has empty unknown parameter: |1=
(
help); Missing pipe in: |url=
(
help)mentions "suicide" headache. SandyGeorgia ( Talk) 19:52, 2 January 2014 (UTC)
“ | The severity of the pain has earned it the sobriquet “suicide headache,” although in our experience this is a rare occurrence in this exceptional patient group. | ” |
This needs to be more explicitly stated in the article, that the pain of cluster headaches can and DOES lead to suicide attempts and completion among sufferers. I have tried to get this put in the article multiple times and despite including sources-- *good* sources and sometimes upwards of five or six for two sentences-- it never sticks. Why, I really don't know, and once again I must stress I feel that this is of utmost importance. I have a couple more sources than just the ones mentioned here but the aforementioned study is indeed the largest that discusses it. The psychological component of this disease is a huge part of management and prognosis, especially with regards to self-harm and suicide, and it's barely even mentioned in the article. I don't have an account so I'm not sure how to sign this. Guest?
^^Great, at least that's something. I went in and fixed two minor typos in the sentence you inserted but it still reads exactly the same. Is there a better place (or any place at all) to attach some of the sources I have on this issue besides the article itself? I may have lost access to some of them as a result of no longer having full(er) access to JSTOR or PubMed-- just can't remember where they all came from-- but I'm fairly certain that I still have at least a few that discuss this. In fact, the largest study that examined this problem at least partially isn't even the one currently cited in the article. It was mentioned above, "Rozen, T., MD, and Fishman, R. "Cluster Headache in the United States of America: Demographics, Clinical Characteristics, Triggers, Suicidality, and Personal Burden," published in Headache in 2011." [3] There are others, so let me know what I can do. (Same guest as above)
This article says the same things over and over and over, often based on primary sources, looking like individual researchers wanted to work their links in. I'm reducing some of the redundant prose, but by no means all of it; that should be done better when the article is thoroughly rewritten to reflect more recent secondary reviews-- since the article is so poorly sourced, it's hardly worth it at this stage to clean up all the prose. SandyGeorgia ( Talk) 21:52, 2 January 2014 (UTC)
There are 2 cochrane reviews, one is already used, here is the other: [3]. Lesion ( talk) 23:07, 2 January 2014 (UTC)
I would really like to improve the discussion that is there now, but I want to do it right. Maybe you can advise me. My concerns relate to these two elements: 1. Vasoconstrictors such as ergot compounds are sometimes used immediately at onset of attack. Cafergot, a vasoconstrictor combination of caffeine and ergot, has been demonstrated in some cases to abort cluster headaches within 40 minutes of ingestion. BOL (2-bromo lysergic acid diethylamide), a non-psychedelic form of the ergot-derived psychedelic LSD, has shown promise in the treatment of cluster headaches.[unreliable medical source?][48] 2. Some isolated case reports suggest that ingesting LSD, psilocybin or cannabis can reduce cluster headache pain and interrupt cluster headache cycles.[49]
Re #1, there really is no relationship between cafergot and BOL-148, except that they both contain ergots (as do some other CH meds mentioned elsewhere in the article). So, I would make a new topic. Re BOL-148, I can edit to provide a link to a peer-reviewed journal, Cephalagia, which published the results of a small trial of BOL-148 for people with CH. But I think that's a "primary source." Would it allow for removing the "unreliable medical source" note that there's now (deservedly so)? BOL-148 is different from cafergot, among other things because it seems to be not just an abortive (and not just an generally ineffectual abortive, as cafergot is) but also a possible preventive. For people with CH, the difference between maybe aborting an attack in 40 minutes and preventing attacks altogether is enormous.
And the fact that BOL-148 works is evidence that the next part -- about LSD, etc. -- is not some whackjobs taking drugs to escape their pain. BOL-148 works because it has LSD in it. So, Re #2. I don't know what "some isolated care reports" means. As far as I know, there is exactly one report of cannabis helping someone, whereas research conducted by medical professionals has shown hundreds of cases in which CH patients receive relief from psilocybin, LSA, and LSA. Yes, these are anecdotal self-reports collected by those medical professionals, and not clinical trials, but since the substances are scheduled, there's no more than that that can be done. I could cite several such reports (and I note that LSA, which is not mentioned in the current text, is the subject of some of them), but again I fear that this will be removed as "primary sources."
There are probably thousands of CH sufferers using LSA, LSD, and psilocybin to treat CH, with no lasting side effects (LSA, for that matter, is effective even without short-term psychedelic "side effects"). I understand someone's reluctance to give this treatment what I think of as its proper attention here -- it's not medically proven; it might sound weird or scary to some people; and the substances are scheduled. At the same time, it is saving lives every day.
If you're going to delete any edits I make, I guess I just won't bother doing so. But if there's a way to provide this information that is consistent with Wikipedia's policies, I would be happy to take a shot at it.~~chfather~~ — Preceding unsigned comment added by Chfather ( talk • contribs) 00:34, 3 January 2014 (UTC)
Another factor in writing for Wikipedia is that Wikipedia text must be verifiable to and rely on secondary sources; we can't engage in original research by analyzing or reporting on primary research studies that haven't been reviewed by secondary sources (that is, independent from the researchers who did the studies)-- our medical sourcing guidelines prefer secondary reviews to primary studies. Primary studies are individual case reports, trials, studies whether controlled or not, animal studies, surveys, and other studies that-- even if published in peer-reviewed journals-- haven't been the subject of a secondary review from independent authors examining their conclusions.
In addition to that, there are a lot of things that Wikipedia is not-- we aren't news, we aren't recent, we aren't for support-- a whole lot of things. We should only be reporting and giving due weight to what other secondary sources have already stated, in encyclopedic tone. An encyclopedia doesn't strive to be current in the same way the daily news does; it strives for long-term accuracy.
To that end, I have gone through and flagged numerous primary sources and laypress reports that don't meet our sourcing requirements, shouldn't have been in the article, and need to be replaced with secondary reviews. I've also removed some text that simply shouldn't be here at all without secondary sources (treatment issues, etc), and flagged the secondary reviews now (correctly) in the article by adding the word "Review" to their citations.
On the topic of psilo/LSD, there is mention of it in one secondary review ( PMID 21352222), and that is in the article now; unless that review has more to say on the topic, or unless other secondary reviews surface, it won't be productive for you to write from laypress or primary sources on the topic of psilo/LSD.
This article was (is) actually in pretty bad shape, making use of very old sources, including a lot of repetitive text and editorializing; I've only made a first pass at cleanup, and some other editors will probably go through soon and try to beef it up. It will benefit everyone for the article to be as good as it can be, as it's not close now!
If you want to know more about how to research for writing medical content on Wikipedia, Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches explains how to locate secondary reviews in PubMed. Regards, SandyGeorgia ( Talk) 03:50, 3 January 2014 (UTC)
Apologies if I'm not putting this in the correct place. I'm just learning method and policy for editing wikipedia. The Dr's Sewell, Halpern and Pope study was cited before someone deleted it. When it was added back the citations didn't come back. As a separate question regarding wikipedia policy: Is there a way to have a separate Cluster Headache article that isn't in the medical documentation category, and therefore information that's not peer reviewed could be added (by primary study instead of secondary?). It seems some life saving information could easily be left out that a sufferer could find life saving. Ie, how sufferers use O2 to stop individual attacks quicker (that doctors don't even know, nor would any study ever be created with secondary review as there are many different ways to use O2. Some ways are nearly useless, like just breathing normally. Many doctors don't even write the scripts correctly for non rebreather mask, LPM etc. Sorry don't mean to be too wordy. Just trying to figure out how to get important (but not peer reviewed) information available to those that find Wikipedia in their online search. Thanks in advance, Jeff — Preceding unsigned comment added by 75.115.201.35 ( talk) 18:50, 6 January 2014 (UTC)
Whether cited to Sewell or not, Sewell is a primary source; we need secondary reviews of it, and on the reading I've done in the last few days (I am not fully caught up yet, still getting the sources and reading through them), we do not have a good review of that study, raising due weight issues.
As to a separate article that is not "medical", it is not the article that matters, it's the content. Medical and health-related content anywhere on Wikipedia needs to meet medical sourcing guidelines. I understand your concern, but it is not Wikipedia's role to advocate, rather to state what secondary sources have already stated in reliable sources. SandyGeorgia ( Talk) 18:57, 6 January 2014 (UTC)
SandyGeorgia, Thanks for the tildes info I was just coming back to add to my post when I saw the responses. Appreciate everyone's patience. AndyTheGrump, I definitely understand the reason and need for primary studies in regards to medical information. No one would want any old yahoo putting any cure they found themselves in Wikipedia (I've seen some crazy and useless "cures" people come up with and completely agree with you). On the other hand the only reason there aren't secondary studies on Psylo is because most Dr's don't want to risk their medical license or medical standing by discussing something that's not legal in most places. On the other hand the back door treatment for many with Cluster Headaches (that aren't treatable by "Dr Approved" methods) really works significantly better (per primary study) than anything that's scriptable by the Docs. As an example the first line treatment most doctors prescribe is Verapamil (off label, because yes, it's not approved for CH treatment), but it's only approx 5% effective. I guess it's a catch 22 that psylo and LSD fall into with CH, which is why I'm fishing for alternative ways to provide the information in a Wikipedia approved manner (referencing the few medical studies on it's effectiveness). Another example; cutting on someone's brain is barbaric (but doctor approved) as compared to taking a small dose of a non Dr approved substance that in the majority of patients stops the attacks. Thanks for the feedback, Jeff 75.115.201.35 ( talk) 19:30, 6 January 2014 (UTC)
the degree to which psilocybin as a treatment for CH's is marginalized in this article is a travesty. — Preceding unsigned comment added by 104.163.140.61 ( talk) 14:51, 7 May 2022 (UTC)
We should remove all names of experts and researchers, and their quotes. Suggest only keep name of the person who discovered it (1974, Ekbom according to one source). Lesion ( talk) 04:24, 3 January 2014 (UTC)
Is cluster headache not alternately referred to as CH? Because switching many of the uses of the phrase cluster headache to CH in the article would probably shave 5KB !! SandyGeorgia ( Talk) 07:03, 3 January 2014 (UTC)
I noted that this article also uses "sufferer" in a few places. The MEDMOS discourages this, instead we should use more neutral wording like "persons with cluster headache". Lesion ( talk) 01:39, 4 January 2014 (UTC)
Done for now-- ready for another pass from Lesion or Jmh649 or Anthonyhcole. SandyGeorgia ( Talk) 16:02, 4 January 2014 (UTC)
I think that was the most dangerous stuff. We have inline tags so have removed the banners from the lead. Feel free to replace them if you feel strongly. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 12:06, 4 January 2014 (UTC)
Under "Prevention," the entry now states: >>The recommended first-line preventative therapy is verapamil, calcium channel blocker.[3][35] Despite its usefulness, only four percent of people with cluster headache report verapamil use.[5]<< I suppose that first sentence is supposed to say "a calcium channel blocker," but my concern is with the second sentence, which is using a 2005 report that was surely compiled in 2004 or earlier -- and although the specific 4% assertion is not cited in that report, it appears to come from even older sources, to judge from the nearby citations. The entry suggests that the 4 percent statistic is current, and there's no justification for that. I don't have more recent information, but the wording is nevertheless misleading. From anecdotal experience, I'd bet that verap is prescribed to at least 40-50 percent of diagnosed people in the US; how many continue using it, I wouldn't know. Chfather ( talk) 02:30, 6 January 2014 (UTC)
We have very good recent reviews on treatment, and we should be using them. I am not able to find that any of them give the weight to psilocybin that we give. PMID 20352587 is a comprehensive, 2010 review, and we have a Cochrane review on oxygen therapy, PMID 18646121, which we are under-using. SandyGeorgia ( Talk) 17:05, 6 January 2014 (UTC)
The use of NBOT in the termination of cluster headaches was supported only by weak evidence from 2 small randomized trials, but given the safety and ease of treatment, the use of NBOT will likely continue. There is insufficient evidence from randomized trials to establish whether HBOT is effective in the acute treatment of cluster headache. Lastly, there was no evidence to suggest that either NBOT or HBOT were effective in the prevention of either migraine or cluster headaches.
[ [4]]
63 people interviewed. The percentage of patients with pituitary abnormalities is interesting. Plus, whoever wrote this CH wiki needs to find sources for the hypothalamus/timetable point. This article should do it. If you wanna get the primary source, this neurologist from sweden has got it all written out for you, since I cant do it myself. So use it if ya wanna. It should be referenced. It makes the most logical sense that the reason the headaches occur in the first place would be associated with the hypothalamus. Ive had them for 4 years, every may for a month. 1 to 3 a day usually. Sometimes i get a day off, but im waiting for it to kick in again the whole time i dont have the CH. Needless to say, Im not looking forward to a month from now.
RossChapman311 (
talk)
06:01, 7 April 2014 (UTC)
"Valproate, sumatriptan and oxygen are not recommended as preventative measures" ref states "Based on current evidence, one review suggested that sumatriptan, valproate (Depacon), misoprostol (Cytotec), supplemental oxygen, cimetidine (Tagamet), and chlorpheniramine should not be used for preventive treatment" [5] Doc James ( talk · contribs · email) (if I write on your page reply on mine) 16:22, 8 October 2014 (UTC)
Some news regarding causes: Naegel S, Holle D, Desmarattes N, Theysohn N, Diener HC, Katsarava Z, Obermann M (2014). "Cortical plasticity in episodic and chronic cluster headache". Neuroimage Clin. 6: 415–23.
doi:
10.1016/j.nicl.2014.10.003.
PMID
25379455.{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) - Open access. --
Friedrich K. (
talk)
13:59, 9 November 2014 (UTC)
"In one study, daily capsaicin was applied in the nose achieved not only desensitization over the next few days to the local pain but also CH relief: "Those who rubbed capsaicin in the nostril on the opposite side of the head had nothing happen. They started out having around 40 attacks a day, and a month later the headaches were still going strong. Those that rubbed capsaicin in the nostril on the side of the head where the headaches were, cut the average number of attacks in half, and in fact half the patients were cured–the cluster headaches were gone completely. All in all, 80% responded, which is at least equal to if not better than all the current therapies out there," as reported by Michael Greger, M.D. and referencing a 2009 peer reviewed study. [4] [5]"
This ref [6] does not mention capsaicin? And this ref [7] is not good enough. Doc James ( talk · contribs · email) 20:59, 4 March 2016 (UTC)
Pain. 1994 Dec;59(3):321-5.
Preventative effect of repeated nasal applications of capsaicin in cluster headache. Fusco BM1, Marabini S, Maggi CA, Fiore G, Geppetti P. Author information Abstract
Preliminary studies have shown that repeated nasal applications of capsaicin prevented the occurrence of cluster headache attacks. The present study was designed to verify the difference in efficacy of treatment with nasal capsaicin, depending on the side of application. Fifty-two patients affected by episodic form were divided into 2 groups, one receiving the treatment on the same side where the attacks occurred (ipsilateral side), the other on the controlateral side. Eighteen patients with a chronic form alternately received both ipsilateral and controlateral treatments. Seventy percent of the episodic patients, treated on the ipsilateral side, showed a marked amelioration whereas no improvement was noted in the patients treated on the contralateral side. The efficacy of ipsilateral treatment was emphasized by the results obtained in chronic patients. However, in these patients, the maximum period of amelioration lasted no more than 40 days. The difference between the effects of the 2 treatments (contralateral and ipsilateral) was statistically significant in both episodic and chronic sufferers. The efficacy of repeated nasal applications of capsaicin in cluster headache is congruent with previous reports on the therapeutic effect of capsaicin in other pain syndromes (post-herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia) and supports the use of the drug to produce a selective analgesia. PMID: 7708405 [PubMed - indexed for MEDLINE]
Btw, this isn't place for discussion but sufferers --I am not one-- may be very interested in personal experiences e.g. Debra-Elaine Simpson's, Junior Hernandez's, TheHusky's at the top fo the comments of that youtube link. The pain level sounds just awful and my heart goes out to sufferers Harelx ( talk) 23:28, 4 March 2016 (UTC) Doc James, if you're ever looking to (also) volunteer at another site, have you seen wikidoc.org? [10] is their about page, started by a Harvard physician..starts off with wikipedia but has medical professionals like you on staff. I really like wikipedia (notwithstanding above) but that seems like a nice sister project, as far as health and medicine. Harelx ( talk) 23:37, 4 March 2016 (UTC)
Found a review here [12] which found the benefit unclear. Doc James ( talk · contribs · email) 06:54, 5 March 2016 (UTC)
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All of this should be edited or removed:
"The cause is unknown.[2] Risk factors include a history of exposure to tobacco smoke and a family history of the condition.[2] Things that may trigger attacks include alcohol, and nitroglycerin.[2] They are a primary headache disorder of the trigeminal autonomic cephalalgias type.[2] Diagnosis is based on symptom.[2]
Recommended management include lifestyle changes such as avoiding potential triggers.[2]"
The text cited is from a 2013 source, and there have since been publications since then describing causes. Also, starting a paragraph about "recommended management" about "lifestyle changes" is irresponsible, since cluster headaches can very rarely be avoided, even if triggers are avoided (need to cite source). — Preceding unsigned comment added by Oholleran ( talk • contribs) 17:59, 5 October 2017 (UTC)
References
Appears to be a very rare differential. As such IMO it is fine to simple go in the body of the article under differential and is not needed in the infobox. Doc James ( talk · contribs · email) 19:34, 7 December 2017 (UTC)
References
doi:10.1016/S1474-4422(17)30405-2 JFW | T@lk 15:32, 18 December 2017 (UTC)
The Journal of Neurology, Neurosurgery and Psychiatry has an interesting piece about how becoming sexually aroused can make a cluster headache go away. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077391/. Is this the only medical condition that can be "treated" by becoming sexually aroused? And does this raise ethical questions about whether health services could or should provide the means of becoming sexually aroused as a form of treatment? Matt Stan ( talk) 15:36, 26 April 2018 (UTC)
I need to sign up to some research project & volunteer my own findings. I've suffered from both migraine & cluster-headaches since childhood, & have a variety of coping strategies for each. lying still in a dark room isn't one of them. but I have found, that against the onset of a cluster-headache, several things help. coffee, marijuana, sugar, coca-cola, sex & bowel-evacuation. some combination of these activities generally helps. the pain of these headaches is not overstated here- I have described my fear to colleagues that one day, one of these headaches will strike while I am in the neighbourhood of my electric drill; trepanation &/or permanent sleep being the objective.
duncanrmi ( talk) 21:55, 9 April 2021 (UTC)
The FDA recently approved an electrical stimulation device (marketed under the name "gammaCore)" to be used to treat cluster headaches. I don't have the expertise to update the "Management" section, but I recommend that someone with the requisite knowledge do so. [A 2018 FDA memo may be a good place to start.] I am aware that other similar devices may become FDA-approved for cluster headache treatment within the next few years, so a new subsection on "electric stimulation devices" may be in order. — Preceding unsigned comment added by Drbb01 ( talk • contribs) 00:35, 19 January 2019 (UTC)
Ref does not make this claim. Doc James ( talk · contribs · email) 01:18, 30 January 2019 (UTC)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738593/ it is used in the body Walidou47 ( talk) 20:52, 6 April 2020 (UTC)
I do not think we need a separate section for one sentence. Doc James ( talk · contribs · email) 17:37, 7 April 2020 (UTC)
The 2006 study referenced in 'research direction' is not really suitable for this section as it's misleading. The study concluded in 2006 and showed significant results in both the management and prevention of CH. I'd therefore like to remove this particular sentence and place the findings of this study under the 'other' sections within prevention and management. Is there any objection to this suggestion? JulianParge ( talk) 16:00, 12 June 2020 (UTC)
What would be the best way to include ongoing research into what seems to be a remarkably effective treatment that has failed to gain much attention yet.
https://n.neurology.org/content/82/10_Supplement/P1.256
There is version/variant of the above protocol in a document "Suggested Headache Preventative Treatment Protocol" .... "prepared for neurologists, pain specialists, and primary care physicians who routinely treat patients with headaches."
Idyllic press ( talk) 10:37, 7 November 2022 (UTC)
Does Wikipedia even allow the content that's written here? All the statements have citations, but it sounds like it was written by a tobacco company. 184.176.138.209 ( talk) 07:36, 27 April 2023 (UTC)