Nav: Home

Zolmitriptan proven effective in combating episodic cluster headaches

May 08, 2000

ST. PAUL, MN - Many patients who suffer from episodic cluster headaches, which are even more painful than migraines, may find rapid relief from the drug zolmitriptan, according to the results of a multinational study reported in the May 9 issue of Neurology, the scientific journal of the American Academy of Neurology.

Zolmitriptan may be taken orally in tablet form while the current most effective way to treat acute cluster headaches is by injection of sumatriptan, a related drug. "There's a natural wish for a tablet or a nasal spray so patients don't have to inject themselves once or twice a day for weeks on end," said Peter Goadsby, MD, of the Institute of Neurology in London, and senior author of the report.

The study included 124 patients in Canada, the United Kingdom and Sweden who took 5-mg or 10-mg doses of zolmitriptan or an inactive placebo pill at the onset of one of the crippling headaches. By the primary measure of the study (a 2-point or greater improvement on a 5-point pain scale), the 10-mg dose relieved pain for 47 percent of patients, whereas the placebo worked for only 29 percent.

Both the 5- and 10-mg doses were significantly more effective than placebo on other pain measures, such as the achievement of mild or no pain at 30 minutes, meaningful headache relief, and a reduced need to resort to other pain remedies (such as analgesics or breathing oxygen). There were no serious side effects associated with either dose of the study drug. "The immediate implication for clinical practice is that the 5-mg dose of zolmitriptan is an appropriate dose to use for patients with acute episodic cluster headaches, provided that they have no more than two attacks in a day," said Goadsby.

But a more important result, said Goadsby, is that the higher dosage was even more effective. While he currently does not recommend the 10-mg oral dose for patients because its safety has not been adequately tested, the fact that it works well suggests administration routes other than injection can deliver the drug rapidly enough to combat the relatively short-lived headaches.

A nasal spray formulation of the drug would be the best alternative, said Goadsby, because it would probably act faster than a tablet and subject the body to less of the drug.

Astra-Zeneca Pharmaceuticals (the manufacturers of zolmitriptan, sold under the name Zomig) are currently considering a nasal spray, said Goadsby.

Cluster headaches are much less common than migraines, affecting only a few people in a thousand, three-quarters of them men. Cluster headaches typically last only one to two hours, but the pain is much more severe than that of migraines. The pain is usually experienced as an intense, penetrating pain behind one eye and is accompanied by other symptoms such as watering, redness and swelling of the eye.

"Cluster headache patients describe the pain as the most severe they have experienced," said Goadsby. "Women with cluster headaches will say that childbirth is no worse."

Typically, cluster headaches are episodic, affecting patients for six to 12 weeks and then going away for up to a year. About 10 percent of patients suffer from headaches year-round. For these unlucky few, the news from the study was not good: as with other drugs that have worked in episodic cluster headaches, oral zolmitriptan was not effective in patients with chronic cluster headache.
The American Academy of Neurology, an association of more than 16,500 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.

For more information about the American Academy of Neurology, visit its Web site at For online neurological health and wellness information, visit NeuroVista at

American Academy of Neurology

Related Pain Articles:

Pain researchers get a common language to describe pain
Pain researchers around the world have agreed to classify pain in the mouth, jaw and face according to the same system.
It's not just a pain in the head -- facial pain can be a symptom of headaches too
A new study finds that up to 10% of people with headaches also have facial pain.
New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.
The insular cortex processes pain and drives learning from pain
Neuroscientists at EPFL have discovered an area of the brain, the insular cortex, that processes painful experiences and thereby drives learning from aversive events.
Pain, pain go away: new tools improve students' experience of school-based vaccines
Researchers at the University of Toronto and The Hospital for Sick Children (SickKids) have teamed up with educators, public health practitioners and grade seven students in Ontario to develop and implement a new approach to delivering school-based vaccines that improves student experience.
Pain sensitization increases risk of persistent knee pain
Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM).
Becoming more sensitive to pain increases the risk of knee pain not going away
A new study by researchers in Montreal and Boston looks at the role that pain plays in osteoarthritis, a disease that affects over 300 million adults worldwide.
Pain disruption therapy treats source of chronic back pain
People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting.
Sugar pills relieve pain for chronic pain patients
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology.
Peripheral nerve block provides some with long-lasting pain relief for severe facial pain
A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.
More Pain News and Pain Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at     You can read The Transition Integrity Project's report here.