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Treatment of Cluster Headache Attacks with Less
Than 6 mg. Subcutaneous Sumatriptan
Gregor N, Schlesiger C, et al.
Posted: November 2005
Headache 2005;45:1069-1072
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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: We designed a prospective open study to
evaluate how many patients benefit from a dose less than 6 mg. SQ
sumatriptan.
Method: 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
40% 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.
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