Which treatment is most effective for acute cluster headaches?

For the management of acute cluster headaches, the most effective treatment is a subcutaneous injection of sumatriptan at a dosage of 6 mg. Sumatriptan is a triptan, a class of medication specifically designed to treat migraine and cluster headache attacks by causing vasoconstriction of cranial blood vessels, which reduces headache pain. This route of administration allows for rapid onset of action, typically providing relief within 15 to 30 minutes, making it particularly suitable for the severe and excruciating pain characteristic of cluster headaches.

Other options, while they may have their uses in headache management, do not provide the rapid and effective relief that sumatriptan offers for acute episodes. Acetaminophen, while helpful for mild to moderate pain, is generally ineffective for the severe pain associated with cluster headaches. Riboflavin is primarily utilized as a preventive treatment rather than an acute intervention, and while verapamil can be effective for prevention of cluster headache episodes, it does not provide immediate relief after an attack has started. Thus, sumatriptan remains the treatment of choice in acute scenarios due to its fast-acting properties and specific efficacy in cluster headaches.