Zolmitriptan Nasal Spray Found Effective and Safe for Cluster Headache

Cluster headache is a primary headache syndrome characterized by attacks of severe unilateral headache typically lasting 30 to 180 minutes without treatment and prominent autonomic symptoms on the affected side. Often attacks occur in cycles lasting weeks to months with up to 8 attacks per day, and a minority of individuals continue to experience attacks throughout the year. Persons with cluster headache usually require both acute medication for attacks and preventive treatment to keep the headaches from occurring. Subcutaneous sumatriptan is the most effective medication for acute cluster attacks, but other triptans such as zolmitriptan nasal spray are also effective. inhaling 100% oxygen is also effective and is a useful treatment for those with frequent attacks or contraindications to triptans. Corticosteroids are among the most effective transitional treatments, typically used at the start of a cycle. Dihydroergotamine is an effective treatment for refractory or severe cluster headache with multiple attacks requiring large triptan doses. Verapamil and lithium are among the most effective preventive medications with good evidence of effectiveness, but other studies support the use of gabapentin, topiramate, diavalproex sodium, and methysergide, to name a few. Each of these medications requires monitoring for adverse events and can be discontinued within a few weeks of a cluster headache cycle.

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Zolmitriptan Nasal Spray: Speed and Efficacy are the Key Drivers of Future Use

Headache Care ◽

10.1185/174234304x14809 ◽

2004 ◽

Vol 1 (4) ◽

pp. 307-309

Author(s):

Nick Syrett ◽

Tim Brandreth

Keyword(s):

Nasal Spray ◽

Key Drivers ◽

Zolmitriptan Nasal Spray

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Zolmitriptan Nasal Spray 5 mg Has a Very Fast Onset of Action and Provides Sustained Pain Relief in the Treatment of Migraine

Headache Care ◽

10.1185/174234304x14665 ◽

2004 ◽

Vol 1 (4) ◽

pp. 261-266

Author(s):

Andrew J. Dowson ◽

Marek Gawel ◽

Bruce R. Charlesworth ◽

Nick Syrett ◽

Graham Wilson ◽

...

Keyword(s):

Pain Relief ◽

Nasal Spray ◽

Onset Of Action ◽

Fast Onset ◽

Zolmitriptan Nasal Spray

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Advances in Medical Management of Cluster Headache

European Neurological Review ◽

10.17925/enr.2009.04.02.95 ◽

2009 ◽

Vol 4 (2) ◽

pp. 95

Author(s):

Stefan Evers ◽

Keyword(s):

Cluster Headache ◽

Surgical Procedures ◽

Acute Treatment ◽

Maximum Dose ◽

Controlled Trials ◽

Scientific Evaluation ◽

First Choice ◽

Daily Dose ◽

Subcutaneous Sumatriptan ◽

Zolmitriptan Nasal Spray

Cluster headache is a rare but extremely disabling condition. For the acute treatment of cluster headache attacks, oxygen (100%) with a flow of at least 7l/minute, 6mg subcutaneous sumatriptan and 5mg zolmitriptan nasal spray are the drugs of first choice. Prophylaxis of cluster headache should be performed with verapamil in a daily dose of at least 240mg (maximum dose depends on efficacy and tolerability). Although no placebo-controlled trials are available, steroids are clearly effective in cluster headache. Methylprednisone (or equivalent corticosteroid) at least 100mg orally or up to 500mg intravenously per day over five days (then tapering down) is recommended. Methysergide, lithium and topiramate are recommended as drugs of second choice. Although in part promising, surgical procedures require further scientific evaluation before they can be recommended.

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Zolmitriptan nasal spray: advances in migraine treatment

Neurology ◽

10.1212/wnl.61.8_suppl_4.s27 ◽

2003 ◽

Vol 61 (Issue 8, Supplement 4) ◽

pp. S27-S30 ◽

Cited By ~ 7

Author(s):

N. Syrett ◽

S. Abu-Shakra ◽

R. Yates

Keyword(s):

Nasal Spray ◽

Migraine Treatment ◽

Zolmitriptan Nasal Spray

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