The intense pain of cluster headaches may not be the only worry for
those patients suffering from them.
Patients with cluster headaches--severe headaches occurring in
clusters of several months and then receding--have a higher rate of
anxiety disorders during the time between clusters of headaches and
show memory deficits during headache clusters, according to a recent
University of Iowa Health Care study.
Ricardo Jorge, MD, associate research scientist in the UI
Department of Psychiatry and lead author of the study, said the
impetus for the study was a previously identified link between
migraines and depression and anxiety. Cluster headaches, similar to
migraines in many ways, were thought to have a similar link,
increasing the likelihood of patients getting mood and anxiety
"If cluster headaches occur frequently with anxiety, the headaches
may cause the anxiety or the other way around," Jorge said. "It is
important to know the relationship between them so that doctors may
treat patients better."
Cluster headaches' intense pain lasts 15 minutes to an hour. This
pain usually occurs over periods that last a few months. After this
time with multiple and severe attacks, the headaches disappear for a
long length of time and then begin again without warning.
The causes of cluster headaches are unknown, but some evidence
suggests changes in blood flow in the brain and dysfunction in
certain brain areas. The incidence of cluster headaches is low, and
cluster headaches affect more men than women, at a ratio of as many
as seven to one. These figures may be somewhat misleading; doctors
are increasingly diagnosing cluster headaches in women, Jorge noted.
The association of cluster headaches and anxiety disorders may
also be related to brain dysfunction, especially certain areas known
to be involved in the development of mood and anxiety disorders,
according to the researchers.
There is no universal treatment for cluster headaches, Jorge said,
although many treatments may be divided into managing the headache
attack or decreasing the number of attacks during a cluster. Oxygen
is often used to alleviate the pain as it happens, while other
medications, including lithium, are used to reduce the length of an
While there may be a link between cluster headaches and anxiety
disorders, more work should be done before attempting to decide how
best to treat patients with both or who are likely to contract both,
"We need a bigger sample and then we will try to replicate our
findings. Then maybe we can see if any specific type of treatment or
approach is needed for those patients with cluster headaches and
anxiety disorders. We also need to further research the significance
of the memory disturbance involved with these headaches," Jorge said.