WebMD Medical News
Louise Chang, MD
Dec. 8, 2009 -- A drug-free option for relief from painful cluster headaches
may be just a breath away.
A large new study offers the best evidence to date backing the use of
high-flow oxygen treatment for cluster headaches. Researchers found 78% of
people who received oxygen treatment reported being pain-free or having
adequate pain relief within 15 minutes of treatment.
Researchers say oxygen treatment for cluster headaches is already a part of
accepted treatment guidelines, but its use has been limited by a lack of
high-quality studies supporting its effectiveness.
Cluster headaches affect about 0.3% of the population and are characterized
by bouts of excruciating pain, usually near the eye or temple on one side. The
attacks can last from 15 minutes to three hours without treatment and may occur
several times a day.
The most effective treatment for cluster headaches is injection with the
triptan drug Imitrex, but use is limited due to potential side effects. Use of
the drug is also not recommended in people with medical problems like coronary
The study, published in The Journal of the American Medical
Association, involved 76 adults with cluster headaches. The participants
treated four cluster headache episodes alternately with either high-flow oxygen
through a face mask for 15 minutes at the start of an attack or regular air
through a face mask. Patients did not know which treatment they were receiving
during each episode.
More than three-fourths of attacks among those who received oxygen treatment
were pain-free or had adequate pain relief within 15 minutes of treatment
compared with 20% of attacks treated with air. Oxygen treatment was also
superior to the placebo air treatment for pain relief at 30 and 60 minutes
after the start of the cluster headache attack.
Unlike with triptan drugs commonly used in cluster headache treatment, no
adverse side effects were associated with the oxygen treatment.
"This work paves the way for further studies to optimize the administration
of oxygen and its more widespread use as an acute attack treatment in cluster
headache, offering an evidence-based alternative to those who cannot take
triptan agents," write researcher Anna S. Cohen, PhD, of the National Hospital
for Neurology and Neurosurgery in London, and colleagues.
SOURCES:Cohen, A. The Journal of the American Medical Association, Dec. 9
2009; vol 302: pp 2451-2457.News release, American Medical Association.
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