The effect of haloperidol administration on relieving cluster headache, probable role of dopaminergic pathway; a double blind clinical trial

Mohammad Mehdi Forouzanfar, Sadrollah Mahmoudi, Hamid Reza Javadzadeh, Alireza Baratloo, Nastaran Sadat Mahdavi, Behrooz Hashemi, Abolfazl Darafarin


Background: The present study was carried out with the aim of assessing the effectiveness of 2.5 mg dose of haloperidol compared with its standard 5 mg dose in relieving symptoms of cluster headaches and finding out to what extent the dopaminergic pathway affects the incidence of cluster headaches.

Methods: The present study is a double-blind randomized clinical trial carried out in 3 health centers, Tehran, Iran. Patients diagnosed with cluster headache were treated by intravenous administration of 2.5 and 5 mg of haloperidol. Using a standard visual analog scale, pain severity was recorded before and 30, 60, 90, and 120 minutes after intervention. Treatment success (at least 3 points decrease in pain severity), side effects and recurrence of the headache were evaluated.

Results: Finally, 42 patients were treated with 2.5 mg dose of haloperidol and 41 were in the 5 mg dose haloperidol treatment group. 40 (95.2%) patients who were treated with 2.5 mg dose of haloperidol experienced a significant decrease in pain (at least 3 points decrease in pain severity) in the initial 30 minutes. During this time, all of the patients (success rate=100%) treated with 5 mg dose of the drug had a significant decrease in pain. The two doses did not have a significant difference regarding treatment success (p=0.42).

Conclusion: Results of the present study showed that both 2.5 and 5 mg doses of haloperidol have similar effectiveness in reducing cluster headaches. The high success rate observed indicates that hyperactivity of dopaminergic pathway plays an important role in onset of cluster headaches.


Cluster Headache; Haloperidol; Dopaminergic Pathways

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