Zolmitriptan nasal spray, used to treat migraine headaches, also may be safe and effective in treating painful cluster headaches, according to an article posted online today that will appear in the November 2006 print issue of Archives of Neurology.
Cluster headaches are characterized by attacks of excruciating pain that typically involve one side of the head and last between 15 and 180 minutes, according to background information in the article. Because the pain is so severe, rapid and effective treatments are needed. Medications known as triptans are typically used to treat migraines; some, including sumatriptan and oral zolmitriptan, have been shown to be effective for cluster headaches as well. Zolmitriptan nasal spray is a new formulation that is absorbed through the nasal passages and acts more quickly. One preliminary study has suggested that the medication could be effective for cluster headache.
Elizabeth Cittadini, M.D., The National Hospital for Neurology and Neurosurgery, Queen Square, London, and colleagues evaulated the use of the nasal spray in 92 patients (80 men, 12 women, average age 40 years) with cluster headaches. Without treatment, the patients' headaches lasted at least 45 minutes. Over the course of the study, the participants each treated three headache attacks: one with placebo, one with 5 milligrams of zolmitriptan nasal spray and one with 10 milligrams of zolmitriptan nasal spray, in random order. Patients were assessed at five, ten, 15 and 30 minutes after taking the medication. If their headache did not subside at 30 minutes, they were allowed to take a different drug to relieve pain.