Efficacy of pharmacological and non-pharmacological interventions in the prophylaxis cluster headache: a systematic review

This systematic review aims to evaluate the efficacy of pharmacological and non-pharmacological prophylactic strategies for cluster headache (CH), a severely disabling primary headache disorder characterized by recurrent, unilateral pain and autonomic symptoms. While pharmacological treatments such as verapamil, lithium, corticosteroids, and galcanezumab have been widely used, recent studies also support the use of neuromodulation techniques (vagus nerve stimulation) as promising non-pharmacological options. Given the debilitating nature of CH and the significant impact on patients’ quality of life, this review seeks to synthesize up-to-date evidence to guide clinical practice and improve long-term management.