A DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL OF INTRANASAL CAPSAICIN FOR CLUSTER HEADACHE

It has been suggested that treatment of cluster headache (CH) patients with topical capsaicin may desensitize sensory neurons by depleting t he nerve terminals of substance P. We attempted to determine whether c apsaicin is effective in aborting CH attacks. Patients in acute cluste r were randomized to receive either capsaicin or placebo in the ipsila teral nostril for 7 days. Patients recorded the severity of each heada che for 15 days. Headaches on days 8-15 of the study were significantl y less severe in the capsaicin group vs the placebo group. There was a lso a significant decrease in headache severity in the capsaicin group on days 8-15 compared to days 1-7, but not in the placebo group. Epis odic CH patients appeared to benefit more than chronic CH patients. Th ese results indicate that intranasal capsaicin may provide a new thera peutic option for the treatment of this disease.