DEAR READER: Thank you for writing. I have printed your letter in the hopes that it will in fact reach those readers who need it most. However, I do have a few issues. First, cluster headaches are fairly easy to diagnose because they follow a pattern, so I am surprised to hear that your husband underwent all this treatment for something that his doctors either couldn’t diagnose or wouldn’t tell him. Second, you did not provide any dosing information. How much ginseng is your husband currently using daily?

I ask that you or any other readers familiar with this write to let me know so I can pass it on to others. Thank you.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

When I was 19 years old, I developed cluster headaches that, at times, became unbearable. I presented all the classic symptoms. Our radiology office was located in a professional building, along with 40 other specialists. At the time, I became a guinea pig. I had everything from Novocain injections into my cervical nerve to histamine injections in my arm, all to no avail. I tried all the known remedies available at the time.

My agony lasted until I was about 33 years old. My episodes were predictable. Every day, they lasted from one minute to several hours, for over a period of six months. Then, just as rapidly as they appeared, they vanished for six months.

Then, as luck would have it, while reading a medical magazine, I spotted an ad from a pharmaceutical company advertising a brand new drug called Sansert, which I believe is now off the market. I asked the radiologist I worked for if he would please contact the company and ask for samples, which he did, knowing that everything else I had tried had failed.

Already in the throes of a cycle, I took the pills according to directions without success. After a period of calm between cycles, I was prepared to make another attempt. Typically, the cycle of pain would ensue and build in crescendo, until reaching its pinnacle, after which it would act in just the opposite manner until I was pain-free; usually all within a minute. Only this time, as soon as the pain started, I popped a pill and did so for one full week, after which I began to notice that the excruciating pain began to abort and then lessen, finally disappearing completely. Then I skipped a cycle, only to become disappointed when it once again returned.

After a period of remission, the pain returned. I immediately began taking the Sansert again with success. After that last bout, at age 33, until this day, I have not had another recurrence.

DEAR READER: To my understanding, Sansert is no longer available in the United States but is still available in other countries. It carries some serious side effects, and this is likely why the United States chose to remove it from the market.

Sansert is chemically similar to lysergic acid diethylamide (LSD), a well-known, potent hallucinogenic that has been purported to relieve the pain of cluster headaches and migraines. To my knowledge, no legitimate research has been done on this subject. I discourage everyone from trying LSD as a treatment because it is an illegal substance that carries stiff legal penalties, not to mention the potentially serious side effects that may last for years in some people.

I bring the similarities of these two substances up only because Sansert carries the side effects of mood changes, hallucinations, delusions and more that are also associated with LSD.

While I am happy to hear that you have success with this drug, there are safer options available. Unfortunately, Sansert has too many strikes against it for me to feel comfortable recommending it to others.

I suggest anyone suffering from cluster headaches be under the care of a neurologist familiar with the condition. Many of my readers with this problem have found relief using supplemental oxygen. Other options include the triptans (sumatriptan, zolmitriptan), local anesthetics (lidocaine, etc.), certain antihypertensives and others. Rarely, surgery may be recommended for those who don’t respond to aggressive treatment or cannot tolerate other treatments.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

The second article was from a mother about her son’s cluster headaches. I have been using essential oils for years now. Peppermint oil on the temples has been effective for migraines and cluster headaches, and also helps to relieve nasal congestion. Anyone who uses this remedy must be careful when using full-strength oils. Many people choose to dilute the oil in half with pure vegetable oil. Petroleum-based oils shouldn’t be used to dilute the essential oils because they can inhibit the effectiveness.

DEAR READER: Thank you for writing to share your experience and to offer help to my readers. Chiropractic manipulation can be beneficial for many conditions that misalign the spine, leading to pain, tingling, numbness and other unwanted symptoms.

Essential oils are primarily used for aromatherapy. They can also be beneficial in alleviating certain symptoms while providing a calming sense of being to relieve stress and help the muscles to relax.

DEAR READER: Cluster headaches can occur every day or over a period of weeks or months. They can occur during a particular season, only to reappear the following year during the same time period. They can strike quickly, without warning, and appear all on the same side of the head. They may be present at the same time on successive evenings, and sufferers can almost set their clocks and calendars by their occurrence. They often occur during the night and appear to most commonly affect middle-aged men.

Symptoms can include a drooping eyelid, stuffy or runny nose, sweating, flushing, tearing, nausea and sensitivity to light.

There is no cure for cluster headaches. The goal is to reduce the severity of pain and shorten the duration of each episode. Treatment focuses on prevention and commonly includes injectible Imitrex except for those people diagnosed with uncontrolled hypertension or ischemic heart disease. In those two instances, Octreotide would be a better choice for control. Beyond that, dihydroergotamine might be used, but is only given in a physician’s office or hospital setting. Xylocaine as a nasal drop remains another choice.

In otherwise healthy people, oxygen, lithium, verapamil and older antidepressants known as tricyclic antidepressants may be beneficial.

Cluster headaches are vascular in nature. Researchers are unsure precisely what causes ADD; however, some considerations include heredity, exposure to high lead levels, brain injuries, nutrition, cigarette smoking and/or alcohol use during pregnancy. Therefore, my interpretation is there is no direct link between ADD and cluster headaches.

In terms of recommending a medication, I believe your son’s best bet is what is prescribed by his physician who knows his complete history. Research remains ongoing and new developments are always on the horizon. Additional information can be obtained through the National Headache Foundation at www.headaches.org.

To give you related information, I am sending you a copy of my Health Report “Headaches”. Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and a $2 check or money order to Newsletter, PO Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print out an order form from my website www.AskDrGottMD.com.

Two years later, they returned once daily. His doctor did an MRI that was normal and diagnosed him with cluster headaches. He was put on heavy doses of steroids that weren’t successful.

He recently began another series. They now occur once daily between 9 p.m. and 11:30 p.m. He went to a neurologist and tried several different medications that were unsuccessful. This time frame and duration fluctuates more, and he skipped two days twice. Pain medications don’t work.

My son has done a lot of research on the Internet. However, so far the legal recommended procedures do not work for him.

Isn’t there anything to relieve the terrible pain he endures, as well as the anxiety he experiences prior to their occurrence? The pain he describes is like he would imagine having an ice pick stuck in his head in the exact same location. He also says he cannot breathe out of his nose during an attack, and his eyes water so that he cannot see. Any help or advice would be sincerely appreciated.

DEAR READER: Your son’s presentation of cluster headaches is textbook. Events may last from weeks to months, followed by periods of remission, when they may stop completely. Remission can be for a month or for several years. The duration of a single attack may be several minutes or, unfortunately, several hours. Attacks commonly occur at the same time each day. Patterns vary from person to person. Unfortunately for your son, his events occur more frequently than the norm, which is one or two annual cluster periods.

Cluster headaches may occur without prior warning. Symptoms include a stuffy or runny nose, restlessness, redness and swelling around the eye on the affected side of the face, and excessive tearing. Most people with the diagnosis avoid lying down during an attack, because the position appears to exacerbate pain.

The cause of the cluster is unknown; however, it is believed tied to an abnormality of the hypothalamus, the portion of the brain that controls many bodily functions to include the nervous and endocrine systems. Chemicals that carry impulses to the brain are thought to be involved as well. Abnormal melatonin and cortisol levels are common during events.

Unfortunately, there is no cure for cluster headaches. Once diagnosed, long-term medication will likely be prescribed. This will likely be backed with short-term medication that may prevent an attack until the long-term drug kicks in. Treatment is directed toward decreasing pain, shortening the duration of events and prevention. Over-the-counter medications are ineffective. A physician, however, might prescribe sumatriptan, commonly used for migraines, zolmitriptan nasal spray, inhaled or IV dihydroergotamine, or oxygen inhaled through a mask. Surgery can be performed only once and can have serious drawbacks.

High altitudes with reduced oxygen levels can be to blame. Avoid alcohol, tobacco smoke, cleaning solvents, oil-based paints, gasoline, heavy fumes, foods such as smoked products and some processed meats that contain nitrates, as well as medications such as nitroglycerine.

Anxiety is common with cluster headaches. Your son might benefit from speaking with a therapist or by joining a support group. He should ask his primary-care physician or neurologist for a reference.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.