Treatment of cluster headache attacks with less than 6 mg subcutaneous sumatriptan.
BACKGROUND
Subcutaneous (SQ) sumatriptan 6 mg is effective in the treatment of acute cluster headache attacks. However, patients sometimes benefit from a dose less than 6 mg.


OBJECTIVE
Therefore, we designed a prospective open study to evaluate how many patients benefit from a dose less than 6 mg SQ sumatriptan.


METHODS
We enrolled 81 consecutive patients with cluster headache and recorded their use of SQ sumatriptan and oxygen. Patients regularly using SQ sumatriptan 6 mg were advised to treat attacks with doses less than 6 mg and with oxygen. Efficacy and side effects of the different treatment options (6 mg, 3 mg, 2 mg, and oxygen) were evaluated.


RESULTS
As a result, 74% of the patients using SQ sumatriptan 3 mg showed efficacy and 89% reported efficacy after 2 mg. Seventy-nine percent reported side effects after the use of SQ sumatriptan 6 mg (29% severe side effects). After the use of 2 mg SQ sumatriptan, only 50% of the patients reported side effects, none of these were classified as severe. Patients' preference was 41% for 6 mg sumatriptan, 28% for doses less than 6 mg, and 31% for oxygen.


CONCLUSIONS
We conclude that sumatriptan in doses less than 6 mg can be effective in the acute treatment of cluster headache attacks. We suggest that patients should have experience in their individual efficacy of sumatriptan doses less than 6 mg.
Gregor
Nora
N
Department of Neurology, University of Münster, Germany.
Schlesiger
Christian
C
Akova-Oztürk
Esra
E
Kraemer
Christoffer
C
Husstedt
Ingo-Wilhelm
IW
Evers
Stefan
S
D000208:Acute Disease; D000280:Administration, Inhalation; D000328:Adult; D003027:Cluster Headache / Q000188:drug therapy*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D018170:Sumatriptan / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D017366:Serotonin Receptor Agonists; D018170:Sumatriptan; D010100:Oxygen