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Sarah* suffers from migraine

 

She’s tried an array of treatments, but the vomiting she experiences may stop oral formulations from working.


 

Her HCP is trying to help, but Sarah finds it hard to talk about her condition.

 


She struggles to identify her triggers and often suffers migraine attacks whilst she’s travelling without the option to stop for a glass of water, meaning tablets aren’t an option.


She’s desperate to speak with her HCP to understand her condition and find a convenient solution.


See how you can communicate with your patients to find a solution that works best for them.
*Representative of a typical patient, for illustrative purposes only.
 

Matthew* suffers from cluster headache


He’s tried different treatments, but the speed of onset and severity of his cluster headache means few treatments can act quick enough to relieve his pain.


Matthew finds it difficult to talk to his HCP about his condition and is struggling to identify the triggers that may be associated with his cluster headaches.

Matthew is desperate to find a treatment that works to stop the severe pain he experiences during his cluster headaches.


See how you can communicate with your patients to find a solution that works best for them.
*Representative of a typical patient, for illustrative purposes only.
 

Recog­nising the symp­toms of migraine and cluster head­aches



Migraine and cluster headache may both be classified according to the International Classification of Headache Disorders (ICHD-3). There are several overlapping symptoms between migraine and cluster headaches that your patients may describe.1 Therefore, it may be challenging to differentiate between migraine and cluster headache diagnoses.


Officially, migraine is defined as a headache on at least 15 days per month.2 Episodic cluster headache occurs in periods lasting between 7 days to 1 year and may be separated by pain-free periods lasting up to 12 months.3


Find out more about different types of migraine and cluster headache
 
 

 

4.5% of the popu­lation expe­rience head­aches at least 15 days per month.2

 

 

Migraine is suffered by 20% of people at some point in their lives.2

 

 

Cluster head­ache is a rare and excru­ciating form of primary head­ache that affects an esti­mated 0.1% of the global popu­lation.4

 



Many women struggle with managing migraine symptoms



Migraine affects women more commonly with a life-time incidence more than twofold vs men.5,6


Some women may feel the need to downplay their symptoms, which means it’s even more important for HCPs to diagnose them properly.


Find out why migraine is a particular problem for women
 



Cluster headache affects men more commonly than women



Unlike migraine, cluster headache affects men most commonly. Men are 4.3 times more likely to experience cluster headaches than women.7


Diagnosis of cluster headache is challenging; 2 out of 3 patients with cluster headache receive a misdiagnosis at their first consultation.8

 

How can you help your patients recognise their triggers?


There are numerous triggers that can set off a migraine and cluster headache attack, making it hard for patients to identify what exactly it is that causes theirs.


Although migraine and cluster headache are distinct clinical conditions, patients might report several common triggers. Triggers common to both migraine and cluster headache may include stress, sleep, alcohol intake, weather changes and pharmacological triggers (histamine, glyceryl trinitrate [GTN], calcitonin gene-related peptide [CGRP]).1 Triggers vary widely from person to person but may commonly fall under these categories.


Other triggers associated with the onset
of cluster headache include:9


  • Strong smelling chemicals including perfume, paint or petrol
  • Overheating during exercise
  • Smoking may be linked with an increased risk of cluster headache

Encouraging patients to keep a record of their experiences and potential triggers could help to identify and avoid problem situations and could help to find more suitable treatment
options.10


Find out more about what can trigger migraine and cluster headaches
 
 

Stress

Sleep

Alcohol intake

Weather changes

Pharmacological
triggers




How to help your patients stand up to migraine and cluster headache



Speed of action may be a source of frustration for patients. Tablets may take between 30–60 minutes to work.11


Over half of patients with migraine suffer from nausea and vomiting too,11,13 which may affect their ability to take oral formulations reliant on gastrointestinal absorption.12


The onset of cluster headache may occur very quickly, meaning a fast-acting treatment is needed. While preventive therapies are the mainstay of treatment for cluster headache (avoiding attacks), acute treatments can offer an interim for patients to provide fast pain relief.14


Find out more about migraine and cluster headache treatments that are fast-acting and don’t rely on gastro­intestinal absorption
 

References:

1. Vollesen AL, et al. J Headache Pain 2018; 19(1): 89.
2. Weatherall MW. Ther Adv Chronic Dis. 2015; 6(3): 115–123.
3. Mayo Clinic. Cluster headache. Available at: https://­www.­mayoclinic.­org/­diseases-conditions/­cluster-headache/­symptoms-causes/­syc-20352080. Last accessed January 2020.
4. May A, et al. Nat Rev Primer 2019; 4: 18006.
5. Stovner LJ & Andree C. J Headache Pain. 2010; 11: 289–299.
6. Sacco S, et al. J Headache Pain. 2012; 13: 177–189.
7. Fischera M, et al. Cephalalgia 2008; 28: 614–618.
8. Ljubisavljevic S & Trajkovic JZ. J Neurol 2019; 266(5): 1059–669.
9. NHS UK, Cluster headaches. Available from: https://­www.nhs.uk/­conditions/­cluster-headaches/. Last accessed December 2019.
10. National Headache Foundation. Headache diary: keeping a diary can help your doctor help you. Available from: https://­headaches.org/­­resources/­­headache-diary-keeping-a-diary-can-help-your-doctor-help-you/.­­ Last accessed December 2019.
11. Gladstone JP & Dodick DW. Pract Neurol. 2004; 4: 6–19.
12. Gajria K, et al. J Pain Res. 2017; 10: 689–698.
13. Lipton RB, et al. Headache. 2013; 53(1): 93–103.
14. Steiner TJ et al. H Headache Pain 2019; 20: 57.