From the Research
Toradol (ketorolac) is not recommended as a first-line treatment for acute cluster headaches due to its slower onset of action and potential limitations. The most recent and highest quality study, published in 2023 in the European journal of neurology 1, provides evidence-based recommendations for the treatment of cluster headache, which prioritize oxygen therapy and subcutaneous sumatriptan as first-line treatments. According to this study, oxygen therapy with a flow of at least 12 L/min over 15 min and 6 mg subcutaneous sumatriptan are strongly recommended for the acute treatment of cluster headache attacks.
Other studies, such as those published in 2023 in Cephalalgia 2 and in 2013 in Headache 3, also support the use of subcutaneous sumatriptan and high-flow oxygen as first-line treatments for acute cluster headaches. Additionally, these studies highlight the importance of preventive treatments, such as verapamil, lithium, and galcanezumab, in managing cluster headaches.
The use of Toradol (ketorolac) may not be the most effective option for acute cluster headaches, given its mechanism of action and potential limitations, including a maximum 5-day use period, risk of gastrointestinal bleeding, and kidney damage with prolonged use. Instead, patients should work with a neurologist to develop a comprehensive treatment plan that may include preventive medications and other evidence-based treatments.
Some key points to consider when treating acute cluster headaches include:
- The importance of rapid and effective treatment to alleviate severe pain and reduce frequency of attacks
- The use of high-flow oxygen therapy and subcutaneous sumatriptan as first-line treatments
- The potential benefits of preventive medications, such as verapamil, lithium, and galcanezumab, in reducing the frequency and severity of cluster headache attacks
- The need for individualized treatment plans, taking into account the patient's specific needs and medical history.