These are potent drugs and should be taken under close supervision and only in the prescribed doses. Sometimes the ergot class of drugs are not successful. In the acute case, pain relievers including narcotics may occasionally be needed. Other drugs including methysergide and cyproheptadine are occasionally used. Propranolol and amitryptilline are two of the most commonly used preventive drugs, and are useful when headaches are occurring with sufficient frequency to interfere with productive daily activities, or when excessive doses of ergots are required.
Nifedipine is such a drug.
Typically, they strike young adult males, often awakening the sufferer at night, confined to one side of the face or head, and often accompanied by tearing or nasal discharge. The pain may be the most severe ever experience, and victims have been said to commit suicide to escape the pain. Thankfully they are usually self-limited and disappear after an hour or so. Therapy has traditionally been similar to that of migraine, although a preventive emphasis is often more prominent. Calcium blockers, as discussed above, may revolutionize therapy as their role becomes better established.