Abstract
We thank Dr. Gupta for his interest in our article.1 Dr. Gupta suggests that a trial of high-dose indomethacin should be considered for patients with chronic cluster headache (CCH). Whether patients with a phenotype of cluster headache (CH), who respond to indomethacin, should be classified as having paroxysmal hemicrania (PH) or indomethacin-responsive CH is unclear. Furthermore, these sparse case reports of indomethacin-responsive CH may be due to a placebo response.2 Headache disorders with the clinical phenotype of either PH or CH that respond to indomethacin should be classified as PH for now, until the pathophysiology of these disorders is better understood.
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