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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


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. Patientsí 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.