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Prevalence approximately 0.1% of the population. Known as 'suicide headaches' due to extreme pain intensity (often rated 10/10).
Acute: high-flow oxygen (100%, 12-15 L/min), sumatriptan injection. Preventive: verapamil, lithium, corticosteroids (short-term bridge), occipital nerve blocks.
Patient-driven research (ClusterBusters) has reported that sub-hallucinogenic doses of psilocybin or LSD can abort cluster cycles and prevent attacks for weeks to months.
Schindler et al. (2015): 19/26 patients reported cluster period termination with psilocybin. Sewell et al. (2006): Survey showed 25/53 psilocybin users reported remission of cluster period.