Spray Could Relieve Cluster Headaches

A nasal spray used to treat migraine headaches may also provide relief from painful cluster headaches.

Researchers found Zomig nasal spray safely and effectively relieved the severe and rapid pain associated with cluster headaches.

Cluster headaches are a type of headache that recurs during a period of time. They cause excruciating pain typically affecting one side of the head and can last from 15 minutes to over two hours. During a cluster period, a person can have multiple headaches. They are different from other types of headaches such as migraine or tension headaches.

Researchers say that because the pain is so severe, fast-acting treatments are needed to treat the cluster headaches. Cluster headaches are difficult to treat. Common treatments include inhaled oxygen treatment, Imitrex (also a migraine drug), and ergot drugs (such as Cafergot).

Zomig is part of a class of drugs called triptans that are commonly used to treat migraine headaches. The nasal spray is a newer formulation of an oral drug that is absorbed through the nasal passages, allowing the drug to act more quickly.

Quick Cluster Headache Relief

Researcher Elizabeth Cittadini, M.D., of the National Hospital for Neurology and Neurosurgery in London, and colleagues, say a preliminary study suggested that Zomig might be effective at treating cluster headaches.

In this study they evaluated use of the drug in a larger group of 92 patients with cluster headaches.

Without treatment, the participants' cluster headaches lasted an average of 45 minutes.

During the study, the participants each treated three headache episodes: one with a placebo, one with a 5-milligram dose of Zomig, and one with a 10-milligram dose of Zomig in random order.

Their pain was assessed at regular intervals to see if they had improvement of moderate, severe, or very severe pain to mild or no pain after 30 minutes. If their cluster headache didn't go away or significantly improve after 30 minutes, the participants were allowed to receive an alternative treatment.

Some of the participants dropped out or did not have enough headaches during the study period, and researchers based their final analysis on a total of 69 patients.

The results showed that patients reported headache relief after 30 minutes in 61 percent and 42 percent of the cluster headaches treated with the 10-milligram and 5-milligram dose of Zomig, respectively, compared with only 23 percent of those treated with the placebo.

Half of the patients treated with the 10-milligram dose of the nasal spray were pain-free at 30 minutes compared with 28 percent of those on the 5-milligram dose and 16 percent who took the placebo.

Researchers say no serious side effects were associated with the use of Zomig to treat cluster headaches in this study. They note that one patient who used the 5-milligram dose of Zomig and experienced shortness of breath, vomiting, and rheumatic pain withdrew from the study. They say the study suggests that Zomig can be used as an initial treatment, along with Imitrex nasal spray or inhaled oxygen in the treatment of cluster headaches.

The results appear in the Archives of Neurology. AstraZeneca, which makes Zomig, supported this research but did not initiate, design, or analyze the study, nor interpret the data. AstraZeneca is a WebMD sponsor.

SOURCES: Cittadini, E. Archives of Neurology, advanced online publication, scheduled for print publication in November 2006; vol. 63. News release, American Medical Association.

By Jennifer Warner
Reviewed by Louise Chang