Here are 02-as-CH-abortive studies:

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  1. Di Sabato F et al. Hyperbaric oxygen in chronic cluster headaches: influence on serotonergic pathways. Undersea & hyperbaric Medicine. 1997; 24(2): 117-22.
  2. Gallagher RM et al. Analgesic use in cluster headache. Headache. 1996; 36(2): 105-7.
  3. Pascual J et al. Preventive effects of hyperbaric oxygen in cluster headache. Headache. 1995; 35(5): 260-1.
  4. Di Sabato F et al. Hyperbaric oxygen therapy in cluster headache. Pain. 1993; 52(2): 243-5.
  5. Fogan L. Treatment of cluster headaches. A double-blind comparison of oxygen v air inhalation. Archives of Neurology. 1985; 42(4): 362-3.

This study (2002) does not mention the 02 flow rate used, but hypothesizes that the cooling effect is more important than the actual use of 02:
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"Titre du document / Document title
Cold room air inhalation to abort cluster headaches: an exploratory study
Auteur(s) / Author(s)
SUE MCLEOD Martha ; ANDRASIK Frank ; PACKARD Russell C. ; MILLER Bayard D. ;
Résumé / Abstract
Research has shown that inhalation of pure oxygen is effective in aborting cluster headache. This article advances the hypothesis that cooling is the critical ingredient behind the effectiveness of oxygen inhalation, rather than the oxygen concentration. To test this hypothesis, eight cluster headache participants used a device that delivered cooled room air as a means to abort headache attacks. Additionally, six of the subjects administered pure oxygen so that comparisons could be made to the air-cooling device. The proportion of cases in which subjects attained effective relief from cluster headache pain by use of the air-cooling device was significantly higher than the proportion of cases in which subjects did not attain effective relief from headache pain. There was no significant difference between the proportion of headaches relieved by oxygen and the proportion of headaches relieved by the air-cooling device. This study raises questions about the mechanisms of action of oxygen inhalation for treating cluster headache, and indicates that future clinical investigations into the use of cold room air for treating cluster headache pain are warranted.
Revue / Journal Title
The Journal of headaches and pain   ISSN 1129-2369
Source / Source
2002, vol. 3, no1, pp. 33-36 [4 page(s) (article)]
Langue / Language
Anglais
Editeur / Publisher
Springer, Milano, ITALIE  (2000) (Revue)
Localisation / Location
INIST-CNRS, Cote INIST : 27383, 35400011594448.0050

Copyright 2008 INIST-CNRS. All rights reserved"


And here is the latest from Dr. Goadsby (2008):
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"Oxygen Therapy Provides Benefits for Treatment of Cluster Headache: Presented at ANA

By Andrew N. Wilner, MD, FACP, FAAN

SALT LAKE CITY, Utah -- September 24, 2008 -- Inhaled oxygen therapy is effective for the treatment of acute cluster headache and should be considered a first-line treatment, according to research presented at the American Neurological Association (ANA) 133rd Annual Meeting.

Peter Goadsby, MD, Headache Center, University of San Francisco, San Francisco, California, presented the study findings here on September 22.

Cluster headache occurs in 0.1% of the population and is the worse kind of pain that people can experience, Dr. Goadsby said. Patients typically experience 1 to 8 headaches a day for 2 to 3 months and then are headache-free for the rest of the year.

Although oxygen therapy has long been touted for the treatment of acute cluster headache, there is only 1 controlled trial in the literature comprising a mere 19 patients to substantiate this claim, Dr. Goadsby observed. Obtaining reimbursement for oxygen therapy for acute cluster headache has been difficult owing to lack of its documented effectiveness, he said.

Dr. Goadsby and colleagues evaluated the efficacy of oxygen therapy in 109 adults who met the criteria of the International Headache Society for cluster headache. Recruitment was performed in conjunction with a cluster headache support group.

During each attack of cluster headache, patients were randomised to treatment using an identical-appearing gas cylinder containing either 100% oxygen or air for 4 separate cluster headaches occurring on different days.

The study was performed between March 2003 and April 2007. Patients who had previously received oxygen treatment were excluded.

A total of 150 headaches were tested with oxygen and 148 with placebo. When assessed after 15 minutes, 78% of the patients treated with 100% oxygen had complete resolution of their headaches, compared with 20% of those treated with air (P < .001). Patients tolerated the oxygen therapy well, Dr. Goadsby said.

He observed that oxygen treatment does not alter the frequency of cluster attacks but is used for the treatment of acute attacks.

Other therapies available include sumatriptan by injection and nasal sprays containing sumatriptan or zolmitriptan.

Dr. Goadsby acknowledged that the mechanism of action of oxygen in treating cluster headache remains unknown.

Now that oxygen therapy has been proven effective, Dr. Goadsby plans to do dose-ranging studies to find the minimal effective dose of oxygen that will be effective to treat acute cluster headache.

[Presentation title: A Randomized Placebo-Controlled Crossover Study of Oxygen in Acute Cluster Headache. Abstract M-93]"

Laurie

The support group that Dr. Goadsby refers to is us, isn't it?  I do remember our members being recruited for a similar study being done by him.

I tried oxygen about 15 years ago, but it was a small emergency tank with the wrong kind of mask.  Needless to say, it did not work so i never tried it again.

With this cycle I got on board here and after reading all the info on oxygen, I reluctantly got all the stuff.

It sure would have been nice to know 35 years ago.

seasonalboomer wrote on Dec 1^st, 2008 at 4:56pm:


Thanks for the great post!
I have no problem with you becoming "evangelists" for O2 and I do feel the compassion of the group...but as one  "who put in the effort to get a proper O2 rig and procedure and still come up empty" time after time.
The feeling of failure or inadequacy or despair makes me feel like each person being recomended O2 should be advised as to the real odds of success.

Maybe i am just feeling a little sorry for myself these days as the CH has the better of me right now.
cheers
Paul

We didn't know why 02 was no longer working for Gary until CH-HELL pointed out that the high level of shadowing probably masks the onset of the actual attack, which simply means he's not catching it soon enough, though for a while there the problem was rebounds, which we now know means he wasn't staying on it long enough - though that's been a moot issue for some time.

We've had a steady supply of 02 since finding this site in 2006 and made a home-made version of a cluster mask (from the old message board) and for several months have had the 02ptiMask.  Em provided some tips on catching it early enough, but he still hasn't got it yet.  

So in answer to your question, FramCire, Gary has no abortives and no preventatives that work.  

I don't know what Paul (or the others that are med-resistant and for whom 02 doesn't work) do.  Occipital Nerve Stimulator may have to be considered at some point, but we're still eliminating meds.

Laurie

Careful, Potter......

"High Oxygen Flow Rates for Cluster Headache"
               by Todd D. Rozen, M.D., Neurologist


As discussed in previous issues of the Headliner, cluster headache patients require effective abortive therapy due to the extreme intensity of their pain. The two most effective cluster abortives are injectable sumatriptan and inhaled oxygen. However, since a large percentage of cluster sufferers are cigarette smokers and at high risk for coronary artery disease, many cannot be treated with the various triptan medications. In these cases, oxygen therapy becomes the preferred option.

Oxygen, the safest of all cluster therapies, is usually prescribed based on a landmark study by Dr. Lee Kudrow. In this study, patients were instructed to use 100% oxygen via a nonrebreather face mask at 7-10 liters/minute. Although usually effective, a certain subset of cluster patients do not achieve relief from this treatment. The author hypothesized that treating patients with higher flow rates of oxygen, up to 15 liters/minute, might provide relief to those sufferers who had not responded to standard oxygen therapy regimens.

Because MHNI has many intractable cluster patients, it was decided that a higher dose of oxygen therapy would be utilized in a few patients. Several important cases recently reported in the medical literature, found this therapy to be quite effective in patients who previously did not respond to lower dose oxygen inhalation.

MHNI's experience indicates patients who do not respond to the standard flow rates should be given the opportunity to use up to 15 liters/minute. However, prior to initiating this therapy, patients must obtain clearance from their primary care physician since serious lung disease and other conditions can make oxygen therapy unsafe or inappropriate. In addition, such oxygen therapy should not be used for more than a maximum of 10-20 minutes at a single setting.

The basis by which oxygen turns off a cluster headache is unknown at this time. Oxygen's constrictive effect on cerebral blood vessels may play a significant role.

Further study and a larger sample size is needed to provide conclusive evidence regarding the usefulness of high oxygen flow rates for difficult-to-treat cluster headache patients.



Headliner is published and privately distributed by the Michigan Head-Pain & Neurological Institute for informational use by our patients and friends. Rights to reproduction belong exclusively to Michigan Head-Pain & Neurological Institute. For additional copies or further information contact:
Jeffrey Pingel, Ph.D., or Scott Madden, Editors, Headliner
Michigan Head-Pain & Neurological Institute
3120 Professional Drive, Ann Arbor, MI 48104


Last modified: 2004