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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Triptans for acute cluster headache.

Simon Law1, Sheena Derry, R Andrew Moore

  • 1Pain Research and Nuffield Department of Anaesthetics, University of Oxford, West Wing (Level 6), John Radcliffe Hospital, Oxford, Oxfordshire, UK, OX3 9DU.

The Cochrane Database of Systematic Reviews
|April 16, 2010
PubMed
Summary
This summary is machine-generated.

Triptans like zolmitriptan and sumatriptan effectively treat severe cluster headaches, offering a convenient alternative to oxygen therapy. Non-oral routes provide faster relief with manageable side effects.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Cluster headache is a severe, disabling neurological condition with limited treatment options.
  • Inhaled oxygen is a first-line therapy, but alternatives like triptans are being investigated.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of triptans for acute cluster headache treatment.

Main Methods:

  • Systematic review of randomized, double-blind, placebo-controlled studies.
  • Searched Cochrane CENTRAL, MEDLINE, and EMBASE databases.
  • Analyzed pain relief, need for rescue medication, and adverse events.

Main Results:

  • Triptans (zolmitriptan, sumatriptan) showed superior efficacy to placebo for headache relief.
  • Subcutaneous sumatriptan 6 mg achieved 15-minute pain relief in 75% of patients (NNT=2.4).
  • Intranasal zolmitriptan 10 mg achieved 30-minute pain relief in 62% of patients (NNT=2.8).

Conclusions:

  • Zolmitriptan and sumatriptan are effective acute treatments for cluster headaches.
  • Non-oral administration routes likely yield better and faster responses.
  • Triptans offer a convenient and potentially safer alternative to ergotamine.