Effect of Ketamine Intranasal Spray in Treatment of Chronic Cluster Headache

Brief Summary

Ketamine has been used clinically IV in a very safe manner by a very small number of clinicians, to treat migraines and CH, and various other rarer pain disorders, including mixed headache and neuropathic pain clinical syndromes. In 5 cases taken from Krusz J.C. headache clinic data in Dallas, Texas US, an intranasal spray of ketamine aqueous solution of 100 µL in one nostril were dosed in treatment of patients with refractory chronic cluster headache as an alternative to IV-treatment (data not published).The net conclusion, at this point, is that intranasal ketamine is a legitimate pharmacologic treatment and is safe and has in one case series proven effective for CH rescue.

The CCH patients will be dosed with an intranasal spray containing 172.5 mg ketamine hydrochloride (150 mg ketamine base) per ml in an aqueous solution. The individual dosing includes 15 mg ketamine in an intranasal sprayed volume of 100 µL given in one nose nostril under supervision of a nurse. The treatment is initiated at T0 under a CH attack when the headache pain exceeds NRS = 6 on an NRS pain scale. The first intranasal dose of 15 mg is given at time 0 and at time intervals of 6 minutes. At 15 minutes after 3 doses (45 mg) it is decided to evaluate whether the patient is sufficiently pain relieved (e.g. NRS < 4) or wants to receive rescue medications instead or if pain is not sufficiently relieved wants to continue until 5 dosing's (75 mg) are received at timepoints T24. The final evaluation of the treatment is performed at T30. Participants are followed up after 1-2 weeks by telehone

Intervention / Treatment

  • Drug: Ketamine

Condition or Disease

  • Cluster Headache

Phase

Study Design

Study type: Interventional
Status: Recruiting
Study results: No Results Available
Age: 18 Years to 60 Years   (Adult)
Enrollment: 20 ()
Funded by: Industry|Other

Masking

Clinical Trial Dates

Start date: Nov 20, 2019
Primary Completion: Mar 31, 2020
Completion Date: Apr 30, 2020
Study First Posted: Nov 27, 2019
Results First Posted: Aug 31, 2020
Last Updated: Nov 29, 2019

Sponsors / Collaborators

Lead Sponsor: N/A
Responsible Party: N/A

Eligibility Criteria

Sex: All
Minimum Age: 18
Maximum Age: 60

This clinical trial is recruiting

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More Details

NCT Number: NCT04179266
Other IDs: 2019-001260-29
Study URL: https://ClinicalTrials.gov/show/NCT04179266
Last updated: Jun 17, 2022