This is just too good to pass up...
Think about it... When was the last time you saw a post saying capsaicin nasal spray is better than sliced bread at stopping the pain of cluster headaches??? I ran a search using the Google search engine at the top of the page for threads that contained "capsaicin" and another search containing "capsaicin" and "worked" or "works." I also ran a third search on "capsaisin" in case there was a typo or it was misspelled.
Of the 27 hits on these search terms there were no conclusive first hand accounts on the efficacy of capsaicins for CH. There was one secondhand account of efficacy from 1999. Two studies on the use capsaicins for CH popped up so I checked ClinicalTrials.gov and found both of them.
The most significant finding of one study of 15 CH'ers using capsaicins sponsored by Winston Labs, who makes "their version of capsaicin" called civamide (zucapsaicin) was a "decrease in the severity of CH pain..."
One of our members actually took part in this study, but was given the placebo... so had no first hand evidence or conclusive comments on the efficacy of civamide (zucapsaicin).
The most authoritative report published in Cephalalgia in 2008 titled: "Treatment of cluster headache in pregnancy and lactation" by Jüergens TP, Schaefer C & May A concluded that among interventional treatments for cluster headache during pregnancy and lactation, "there is insufficient experience with pizotifen, melatonin and capsaicin."
Dr. Arne May MD, Professor of Neurology, Department of Systems
Neuroscience, University Clinic Hamburg Eppendorf (UKE), is a square shooter. If there is clear medical evidence of efficacy for a particular method of intervention for CH... he'll tell you. If it's unclear or doesn't exist, he'll tell you that as well... Dr. May is also the principal author of the EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias listed in the National Guideline Clearinghouse.
I had the opportunity to spend a couple days meeting with Dr. May and tour his facilities at the University Clinic Hamburg Eppendorf (UKE). He spends half his time in the lab doing functional neuroimaging and the other half doing clinical work seeing mostly patients suffering from migraines and CH...
He's done several studies of cluster headache sufferers using functional neuroimaging. He's also done a similar functional neuroimaging study involving experimental pain induced by capsaicin injection into the forehead. From his functional neruoimaging studies, he's seen no benefit from capsaicins for CH'ers.
Prof. Dr. May has a fascinating article on cluster headaches in the Oxford Journals titled:
Headache: lessons learned from functional imaging. In this article, he provides a compelling argument based on his studies using functional imaging on the age old question... Are cluster headaches neurogenic or vascular? See the following link:
Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

or

Having said all that, there may a potential benefit from capsaicins, but IMHO, you don't get it by spraying it up your nose or shooting it up your back side... You eat hot peppers... or pepper sauce.
Eating hot peppers or putting pepper sauce on food doesn't appear to do anything for CH, but our brains react to this irritant by dumping endorphins (endogenous opioid peptides) into the bloodstream and in short order, we get a pleasant buzz... Runners get it and it's called the "runner's high."
I've know several die-hard marathoners that start going through withdrawal as bad as the Mad Viking when he was hooked on morphine if they go more than a few days without a "fix" from running three to four miles... I've also worked others who went through similar withdrawal symptoms if they didn't get "hot sauce" on their food.
I've gone through a couple pounds of Jalapeños and a bottle of Chipotle Tabasco sauce a week and although I got a pleasant buzz, they had no effect on the frequency or intensity of my CH.
Bottom line... while you might get a buzz from eating hot peppers or hot sauce, capsaicins appear do little for CH. Moreover, from the information I've read from credible sources regarding the efficacy of capsaicins as an intervention for cluster headache... as they say on the TV series
MythBusters... "BUSTED."
Take care,
V/R, Batch