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The Bipolar Spectrum in Cluster Headache Patients
(See Source References)
Posted: December 2003  
Breslau N, Merikangas K, Bowden CL:
Comorbidity of Migraine and Major Affective Disorders.
Neurology S  1994; 44:S17-22.
Robbins L, Ludmer C: The Bipolar Spectrum in
Migraine Patients. The American Journal of Pain
Management 2000, Vol. 10, No. 4, pp. 167-170.

The participant should be able to recognize cluster headache, and be aware of the increased incidence of bipolar illness among both migraine and cluster patients.

1. Breslau N, Merikangas K, Bowden CL: Comorbidity of Migraine and Major Affective Disorders. Neurology S 1994; 44:S17-22.
2. Robbins L, Ludmer C: The Bipolar Spectrum in Migraine Patients. The American Journal of Pain Management 2000, Vol. 10, No. 4, pp. 167-170.

Objective and Introduction:   The purpose of this study was to determine the incidence of the bipolar spectrum in a large number of cluster headache patients. Previous research has revealed an increase in bipolarity among migraine patients (1). One previous study of 1000 migraineurs indicated that 8.6% were bipolar (2).

Methods:   275 consecutive cluster headache patients, seen over a period of 17 years, were evaluated. The age range was 20 to 78, with an average age of 49. There were 170 men and 105 women. Chart review, as well as interviews with patients and families, was accomplished by the treating neurologist. Lifetime prevalence of bipolar was assessed. Bipolar illness was defined according to DSM-IV. Inclusion criteria were: age 20 or older, and a history of cluster headache as defined by the International Headache Society Criteria.

Results:   Of the 275 cluster patients, 134 had episodic cluster, and 141 were chronic cluster sufferers. EPISODIC CLUSTER: 8 patients (6%) fit the bipolar spectrum. 1 patient was bipolar I, 4 were bipolar II , 2 were cyclothymic, while 1 was bipolar NOS. CHRONIC CLUSTER: 10 patients (7%) were bipolar. 2 were bipolar I, 2 bipolar II, 4 cyclothymic, while 2 were bipolar NOS. COMBINED: 18/275 patients (6.5%) were bipolar. 1.1% were bipolar I, 2.2% bipolar II, 2.2% cyclothymic, and 1.1% bipolar NOS.

Conclusion:   This study indicates that, as with migraine, bipolar is seen with an increased frequency among cluster patients. Certain medications, such as sodium valproate, may be beneficial in treating both illnesses.