Mig not especially useful for Cluster. Action is too slow and inconsistent.

Studies support this spray:

Neurology. 2007 Aug 28;69(9):821-6.  
Zolmitriptan nasal spray in the acute treatment of cluster headache: a double-blind study.

Rapoport AM, Mathew NT, Silberstein SD, Dodick D, Tepper SJ, Sheftell FD, Bigal ME.

Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. alanrapoport@gmail.com

OBJECTIVE: To evaluate the efficacy and tolerability of zolmitriptan 5 mg and 10 mg nasal spray (ZNS) vs placebo in the acute treatment of cluster headache. Design/ METHODS: We conducted a multicenter, double-blind, randomized, three-period crossover study using ZNS 5 mg, ZNS 10 mg, and placebo. Headache intensity was rated by a 5-point scale: none, mild, moderate, severe, or very severe. The primary efficacy measure was headache response (pain reduced from moderate, severe, or very severe at baseline, to mild or none) at 30 minutes. Logistic regression was used to account for treatment period effect as well as for cluster headache subtype effect. RESULTS: A total of 52 adult patients treated 151 attacks. For the primary endpoint, both doses reached significance at 30 minutes (placebo = 30%, ZNS 5 mg = 50%, ZNS 10 mg = 63.3%). For headache relief, ZNS 10 mg separated from placebo at 10 minutes (24.5% vs 10%). Zolmitriptan 5 mg separated from placebo at 20 minutes (38.5% vs 20%). For pain-free status, ZNS 10 mg was superior to placebo at 15 minutes (22.0% vs 6%). Both doses had higher pain-free rates than placebo at 30 minutes (placebo = 20%, ZNS 5 mg = 38.5%, ZNS 10 mg = 46.9%). Side effects were mild and seen in 16% of those attacks treated with placebo, 25% of attacks treated with ZNS 5 mg, and 32.7% treated with ZNS 10 mg. Conclusions/Relevance: Zolmitriptan nasal spray, at doses of 5 and 10 mg, is effective and tolerable for the acute treatment of cluster headache.

Publication Types:
Research Support, Non-U.S. Gov't

PMID: 17724283 [PubMed]

Migranol also worked quite well as a CH killer for me - once - but I had the same BP spike as you, Ray.

Zomig nasal spray (zolmitriptan on Bob's article) works very, very quickly and effectively for me IF I use it right away.

My standard approach is to apply the spray, then hit the O2. Makes the world a wonderful place.........

NOW RAY!! I haven't achieved the status of God-head yet. <bg>

But curious to search PubMed and could find only one abstract on the use of the inhaler form in CH--and look at the date. Suggests this has not been a market killer!
============
Dihydroergotamine nasal spray in the treatment of attacks of cluster headache. A double-blind trial versus placebo.

Andersson PG, Jespersen LT.

Cephalalgia. 1986 Mar;6(1):51-4.

PMID: 3516408 [PubMed]

I used the imtirex nasal spray for years and it worked just as fast as the shot 6-10 min.  Just to let you know there is an alternative out there besides the zomig nasal spray.  The imtirex ns comes in 10mg and 20mg doses.  I found I could take 2 20mg a day max or 4 10 mg a day max.  The 10 mg was more than suffiencient for me to abort me ch.

Migrinal worked great for me. Very reliable and fast acting. I did not get the stuffiness reported by other users, or I was so relieved the attack was over I didn't notice.

micheal wrote on Mar 12^th, 2009 at 8:25pm: