New Treatment Explored for Cluster Headaches

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The most common form of cluster headaches is marked by sudden attacks over periods of one to two months, during which time a person may experience between one and three attacks a day, said Rapoport, now a clinical professor of neurology at the University of California, Los Angeles, David Geffen School of Medicine. About 14 percent of people with cluster headaches have an inherited form that runs in families, he added.

Dr. Charles Flippen, of the UCLA Headache Research and Treatment Program, said the new research "gives us another bow in the quiver, so to speak. It's been established that triptans are effective medication for cluster headaches. Right now, the gold standard is subcutaneous sumatriptan. Because of the delivery method for that medication, there is a relative limit on how many doses you have within a day or week's period of time," he said.

"The [zolmitriptan] nasal spray will allow a little more dosing within that period of time," Flippen said, although the U.S. Food and Drug Administration has not yet approved this usage or a standard for dosages. The spray is "another method of helping a small but significantly comprised group of patients that suffer from a disorder than has a limited number of therapeutic options," he added.

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Rapoport said the 52 study participants, aged 23 to 65, used the zolmitriptan nasal spray at most to manage only three attacks of individual episodes. The study didn't show what side effects might occur with more frequent usage, he added. Before the FDA will consider approval of the drug for cluster headaches, a longer-term study is likely needed, he said.

Dr. Seymour Diamond, executive chairman of the National Headache Foundation, said he is concerned about the use of triptans such as zolmitriptan. He said he'd be "very cautious" about using triptans in anyone over age 55 because of the potential cardiovascular effects.

"I wouldn't mind if a patient took it for one attack, but I would be very hesitant to use it in my practice prophylatically, on a daily basis," Diamond said.

More information

Learn more about cluster headaches from the American Academy of Family Physicians.

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