The latest study suggests that a nasal spray used for the treatment of migraine headaches is also helpful in relieving the pain of extraordinarily debilitating "cluster" headaches.
The nasal spray - zolmitriptan (Zomig) – can lead to very few side effects. It appears to work by targeting nerves carrying pain signals. "It appears to be very convenient and absolutely secure," said the co-author of the research, Dr Peter Goadsby, professor of clinical neurology at University College London. "It is good news for patients."
Cluster headaches are considerably less frequent than migraines, striking about only one in one thousand people. They usually appear in clusters once or twice a year, resulting in attacks once or twice a day for two to three months, Goadsby claimed.
The exact causes of cluster headaches are not clear yet. They seem to be associated with cycles of light and dark. Goadsby claims that the clusters are most widespread around the spring and fall equinoxes, and the headaches themselves frequently happen at specific times in the course of the day, such as 1 pm, 10 pm and 4 am. "You can almost set a clock by what happens," Goadsby explains.
Hard to tolerate
The attacks themselves are "rather unique". They take about two hours but on one side of the head only, Goasdsby claims. Unluckily for patients, the headaches are enormously difficult to tolerate. "A cluster is like a hot poker in the eye," said Dr Stephen Silberstein, director of the Jefferson Headache Center at Thomas Jefferson University Hospital in Philadelphia and spokesman for the American Headache Society.
There are available methods of treatment for cluster headaches, such as pure oxygen and a variety of medications, however they are not equally effective for all patients. Enter the nasal spray known as zolmitriptan, which is used for the treatment of migraines.
In the latest research, the scientists tested the spray on ninety two patients- eighty men, the gender at greater risk of experiencing cluster headaches. Due to the fact that some patients dropped out of the research or did not have enough headaches in the course of the research, only sixty nine patients were included in the final analysis.
The participants were randomly assigned by the scientists to be treated with a placebo, 5 milligrams of the nasal spray, or 10 milligrams when their headaches appeared. Then, they were checked several times over a half-hour period. If the headaches did not improve after that time, the patients were permitted to try another method of treatment.
The study was funded by AstraZeneca, the producer of the nasal spray. The results of the research were published in the November issue of Archives of Neurology.
The findings
After thirty minutes, patients who took the 10-milligram dose reported the improvement 61 per cent of the time, in comparison with 42 per cent and 23 per cent of patients who took the smaller dose and the placebo, respectively.
Those patients who were given the 10-miligram dose were pain-free at a half hour about 50 per cent of the time, in comparison with 28 per cent and 16 per cent of those who took the smaller dose and the placebo, respectively. In accordance with the research, one patient dropped out after experiencing shortness of breath, vomiting and joint pain.
Goadsby explained that the nasal spray is easy to use, and publicity about the study should both elevate the profile of cluster headaches (which frequently are not recognized) and improve treatment.
Silberstein, who has obtained funding from AstraZeneca and is acquainted with the findings of the research, agreed that the nasal spray is now a good treatment for cluster headaches. "It’s a way of coping with the attack until it gets under control with preventive medicines," he explained. Silberstein says that the medication appears to work by targeting nerves that carry pain and turning them off.
