Treatment of Cluster Headache Attacks With Less Than 6 mg Subcutaneous Sumatriptan

Abstract

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.

Survey Analysis of the Use, Effectiveness, and Patient‐Reported Tolerability of Inhaled Oxygen Compared With Injectable Sumatriptan for the Acute Treatment of Cluster Headache

“…One such trial reported an efficacy for oxygen of 66.7% against 98.0% for 6 mg injectable sumatriptan (after 15 minutes), though this study population was not medication‐naïve and included a high number of known sumatriptan responders and fewer known oxygen responders . Furthermore, the oxygen flow rates (at least 7 L/min) and masks (not specified) could not be verified to be optimized . Presently, injectable sumatriptan would appear to be the most appropriate comparator to oxygen; in the current survey analysis, both therapies were effective when oxygen was inhaled at sufficiently high rates.…”

“…Despite being a mainstay treatment for cluster headache, oxygen is still considered investigational by the Centers for Medicare & Medicaid Services, thus hindering its usage in this disabling condition. There are several prospective studies investigating oxygen in cluster headache . One such trial reported an efficacy for oxygen of 66.7% against 98.0% for 6 mg injectable sumatriptan (after 15 minutes), though this study population was not medication‐naïve and included a high number of known sumatriptan responders and fewer known oxygen responders .…”

“…There are several prospective studies investigating oxygen in cluster headache . One such trial reported an efficacy for oxygen of 66.7% against 98.0% for 6 mg injectable sumatriptan (after 15 minutes), though this study population was not medication‐naïve and included a high number of known sumatriptan responders and fewer known oxygen responders . Furthermore, the oxygen flow rates (at least 7 L/min) and masks (not specified) could not be verified to be optimized .…”

Italian guidelines for primary headaches: 2012 revised version

“…Sumatriptan s.c. (6 mg) has been shown to be effective both on pain and associated symptoms [248–250]. When administered for long periods, it maintains its efficacy without tachyphylaxis and with a good safety profile [251, 252].…”

Recommandations pour le diagnostic et le traitement de l’algie vasculaire de la face

“…L'effet est souvent plus rapide, permettant de contrôler la crise en 5 à 10 minutes (AP). Des doses de moins de 6 mg (3 mg et 2 mg) peuvent éga-lement être efficaces (grade C) [63]. En l'absence de contre-indications (pathologies cardio-et neurovasculaires, l'hypertension artérielle non contrôlée, allergie aux sulfamides), le sumatriptan est un traitement de première intention de la crise d'AVF.…”