PREVENTATIVE EFFECT OF REPEATED NASAL APPLICATIONS OF CAPSAICIN IN CLUSTER HEADACHE

Preliminary studies have shown that repeated nasal applications of cap saicin prevented the occurrence of cluster headache attacks. The prese nt study was designed to verify the difference in efficacy of treatmen t with nasal capsaicin, depending on the side of application. Fifty-tw o patients affected by episodic form were divided into 2 groups, one r eceiving the treatment on the same side where the attacks occurred (ip silateral side), the other on the controlateral side. Eighteen patient s with a chronic form alternately received both ipsilateral and contro lateral treatments. Seventy percent of the episodic patients, treated on the ipsilateral side, showed a marked amelioration whereas no impro vement was noted in the patients treated on the contralateral side. Th e efficacy of ipsilateral treatment was emphasized by the results obta ined in chronic patients. However, in these patients, the maximum peri od of amelioration lasted no more than 40 days. The difference between the effects of the 2 treatments (contralateral and ipsilateral) was s tatistically significant in both episodic and chronic sufferers. The e fficacy of repeated nasal applications of capsaicin in cluster headach e is congruent with previous reports on the therapeutic effect of caps aicin in other pain syndromes (post-herpetic neuralgia, diabetic neuro pathy, trigeminal neuralgia) and supports the use of the drug to produ ce a selective analgesia.