[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-436321-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-436321-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","acute-and-preventive-medical-treatment-of-cluster-headache-in-taiwan-a-narrative-review","Acute and preventive medical treatment of cluster headache in Taiwan - A narrative review","","Cluster headache (CH) is a disabling neurological disorder marked by severe unilateral pain and ipsilateral autonomic symptoms. In Taiwan, chronic CH is exceptionally uncommon, comprising about 1% of cases. This narrative review summarizes current acute and preventive treatment strategies used in Taiwan, emphasizing available pharmacological options. Management follows a stepwise approach: high-flow oxygen and triptan nasal sprays for acute relief, transitional steroids for bridging, and verapamil as first-line prevention, with lithium or topiramate as alternatives.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/acute-and-preventive-medical-treatment-of-cluster-headache-in-taiwan-a-narrative-review/436321/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/acute-and-preventive-medical-treatment-of-cluster-headache-in-taiwan-a-narrative-review/436321.png","ImageObject",300,407,{"name":42,"@type":43},"Margaret","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-09","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What are the main acute treatments for cluster headache in Taiwan?","Question",{"text":63,"@type":64},"High-flow oxygen inhalation and triptan nasal sprays are the mainstays of acute treatment, providing rapid relief with good tolerability.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does Taiwan’s treatment approach connect acute therapy to long-term prevention?",{"text":68,"@type":64},"Transitional treatments such as oral steroids and suboccipital steroid injections act as a bridge between acute and long-term preventive therapies, offering temporary relief while limiting side effects through a carefully limited duration.",{"name":70,"@type":61,"acceptedAnswer":71},"Which medications are recommended for preventive treatment of cluster headache?",{"text":72,"@type":64},"Verapamil is the first-line preventive option, while lithium and topiramate are second-line alternatives; among CGRP monoclonal antibodies, galcanezumab shows efficacy for preventing episodic CH.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},436321,1790849552,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":118,"preview_page_count":4},137451207643,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","J Chin MedAssoc  \nReview ARticle  \nAcute and preventive medical treatment of cluster headache in Taiwan: A narrative review  \nFu-Chi Yanga, Chia-Lin Tsaia, Guan-Yu Lina, Chun-Pai Yangb,c,*, Wei-Ta Chend,*  \naDepartment of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; bDepartment of Neurology, Kuang Tien General Hospital, Taichung, Taiwan, ROC; cPh.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC; dDepartment of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan, ROC  \nAbstract  \nCluster headache (CH) is a debilitating neurological disorder characterized by severe, unilateral pain, and ipsilateral autonomic symptoms. Chronic CH is exceedingly rare in Taiwan, constituting approximately 1% of all CH cases. This narrative review providesan up-to-date overview of the acute and preventive treatment strategies for CH in Taiwan, focusing on currently available pharmacological options in the country. The treatment approach for CH in Taiwan involves a stepwise strategy. High-flow oxygen and triptan nasal sprays are the mainstays of acute treatment, providing rapid relief, and good tolerability. Transitional treatments, such as oral steroids and suboccipital steroid injections, serve as a crucial bridge between acute and long-term preventive therapies, offering temporary relief while minimizing side effects through a carefully limited duration. For preventive treatment, verapamil is the first-line option, with lithium and topiramate being the second-line alternatives. Among the calcitonin gene-related peptide (CGRP) monoclonal antibodies, galcanezumab has demonstrated efficacy in the prevention of episodic CH. Preventive treatments are personalized to individual patients, starting with low doses and close monitoring for adverse effects. Neuromodulatory therapies, such as noninvasive vagus nerve stimulation, show promise for chronic and refractory CH but have limited availability in Taiwan. In conclusion, despite the availability of various acute and preventive treatment options, unmet needs in the management of CHin Taiwan remain. In particular, increased awareness and education among healthcare professionals to improve the diagnosis and management of CH in Taiwan should be implemented.  \nKeywords: Cluster headache; Steroid; Triptans  \n1. INTRODUCTION  \nCluster headache (CH) is a debilitating condition characterized by intense, unilateral pain, often accompanied by autonomic symptoms.1,2 Because the prevalence and clinical presentation of CH can vary, understanding the distinction between its two main forms, episodic and chronic, is essential for effective management. Episodic CH, the more prevalent form, is defined by recurring headache attacks lasting from 7 days to 1 year, interspersed with pain-free intervals of 3 months or longer. In contrast, chronic CH manifests without significant remission periods, with sufferers experiencing attacks that persist for over a year or allowing only brief remission periods of \u003C3 months. In Taiwan, chronic CH is exceptionally rare, affecting only about 1% of all CH patients; however, studies from Western countries have reported a higher prevalence of chronic CH, ranging  \n*Address correspondence. Dr. Chun-Pai Yang, Department of Neurology, Kuang Tien General Hospital, 117, Shatian Road, Shalu District, Taichung 433, Taiwan, [ROC. E-mail address: neuralyung@gmail.com](ROC. E-mail address: neuralyung@gmail.com) (C.-P. Yang); Dr. Wei-Ta Chen, Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, 268, Shin-Erh Road, Keelung 201, Taiwan, ROC. E-mail address: wtchen@kln.mohw. [gov.tw](gov.tw) (W.-T. Chen).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2024) 87: 912-919.  \nReceived October 28, 2023; accepted June 17, 202","cbCaiiX2hVsLeMyo","https://ap.wps.com/l/cbCaiiX2hVsLeMyo","pdf",422402,"English","# Introduction\n## Cluster headache forms: episodic vs chronic\n# Treatment focus in Taiwan\n## Acute management options\n## Transitional bridging therapies\n## Preventive strategies\n# Conclusion and unmet needs","[{\"question\":\"What are the main acute treatments for cluster headache in Taiwan?\",\"answer\":\"High-flow oxygen inhalation and triptan nasal sprays are the mainstays of acute treatment, providing rapid relief with good tolerability.\"},{\"question\":\"How does Taiwan’s treatment approach connect acute therapy to long-term prevention?\",\"answer\":\"Transitional treatments such as oral steroids and suboccipital steroid injections act as a bridge between acute and long-term preventive therapies, offering temporary relief while limiting side effects through a carefully limited duration.\"},{\"question\":\"Which medications are recommended for preventive treatment of cluster headache?\",\"answer\":\"Verapamil is the first-line preventive option, while lithium and topiramate are second-line alternatives; among CGRP monoclonal antibodies, galcanezumab shows efficacy for preventing episodic CH.\"}]","Acute and preventive medical treatment of cluster headache in Taiwan - A narrative review | PDF",1790677609]