We investigated the efficacy and tolerability of 20 mg
sumatriptan nasal spray in the acute treatment of
cluster headache attacks in an open-label study. 10 patients met the criteria of the International
Headache Society (IHS) for episodic or
chronic cluster headache and were enrolled in our study. The primary efficacy measure was "
pain free" 30 minutes
after treatment. Secondary end-points included "
headache response" (defined as
headache improvement from "very severe", "severe" or moderate"
pain to "mild" or "no"
pain) 15, 30, 45 and 60 minutes
after treatment. We also assessed the participant's overall treatment satisfaction at the end of the study.
Sumatriptan nasal spray was applied in 154 "moderate" to "very severe"
cluster headache attacks. 30 minutes after
nasal spray application, 50% of attacks were completely aborted and 58% of attacks responded to treatment. The overall efficacy of
sumatriptan nasal spray was considered "excellent" in two, "good" in four, "reasonable" in two and "poor" in two patients. Eight patients indicated their intention to treat further attacks with intranasal
sumatriptan. Seven patients were interviewed after a follow-up period of six months. Four patients continued to treat all
cluster headache attacks with the intranasal
sumatriptan formula, two patients had switched to subcutaneous
sumatriptan and one patient was in remission since the end of the study. We conclude that 20 mg
sumatriptan nasal spray might be an alternative
therapy for the treatment of
cluster headache attacks, but double-blind studies are needed to further evaluate its efficacy.