Capsaicin jelly against migraine pain

Area of Science:

• Neurology
• Pain Management
• Pharmacology

Background:

• Extracranial perivascular afferents, particularly in the superficial temporal artery, play a role in migraine pain.
• These afferents release peptides like calcitonin gene-related peptide (CGRP) and substance P (SP), implicated in migraine genesis.
• Capsaicin, a transient receptor potential vanilloid type 1 agonist, can inactivate sensory neurons and has shown efficacy in neuropathic pain.

Purpose of the Study:

• To investigate the efficacy of topical periarterial capsaicin in alleviating scalp artery pain.
• To determine if topical capsaicin provides relief in the absence of a migraine attack.
• To assess the effectiveness of topical capsaicin during a migraine attack.

Main Methods:

• Twenty-three migraineurs with scalp artery pain were treated with topical capsaicin 0.1% or vaseline on painful arteries.
• The comparison was made in the absence of a migraine attack.
• For patients with >50% pain reduction, the same comparison was repeated during a mild- to moderate-intensity migraine attack.

Main Results:

• Topical capsaicin achieved >50% reduction in arterial pain in 17 out of 23 patients, compared to 2 with vaseline, in the absence of an attack.
• During migraine attacks, >50% pain improvement was observed in 11 out of 17 patients treated with capsaicin, versus 1 with vaseline.
• Scalp arterial tenderness was a key factor in patient selection.

Conclusions:

• Topical capsaicin demonstrates potential for relieving arterial pain in migraineurs with scalp arterial tenderness, both between and during attacks.
• The findings suggest topical capsaicin may represent a novel therapeutic approach for managing migraine attacks.
• Further research with more potent capsacinoids is warranted to explore new migraine treatment strategies.