INTRANASAL MEDICATIONS FOR THE TREATMENT OF MIGRAINE AND CLUSTER HEADACHE

Intranasally administered medications for the treatment of headache ha ve recently received increased attention because they offer a rapid on set of activity, even in patients with nausea and vomiting. In additio n, patients are likely to use intranasal agents earlier in the course of a headache attack because the intranasal route overcomes potential patient objections to administration of agents by injection and suppos itory. Although not yet widely available, intranasally administered he adache medications are likely to enjoy widespread acceptance once intr oduced to markets worldwide. At present, butorphanol nasal spray is av ailable for use in severe headache and other pain syndromes only in th e US. This drug is a synthetic opioid agonist-antagonist and thus is u seful for pain control when an opioid is required. Dihydroergotamine n asal spray has recently become available in Canada, and should be avai lable in the US and other countries in the near future. Sumatriptan na sal spray has recently been approved in The Netherlands and should soo n be available throughout Europe. Other abortive migraine agents may b ecome available in tablet or capsule form and later for nasal administ ration. Capsaicin, lidocaine (lignocaine) and calcitonin have been use d for relief of migraine and cluster headache, but have not yet been w idely accepted.