INTRODUCTION: The objective is to analyse our experience with the new intranasal 
formulation of zolmitriptan 5 mg in the symptomatic treatment of cluster 
headache in daily clinical practice.
PATIENTS AND METHODS: We collected a total of 18 patients with cluster headache 
and experience with intranasal zolmitriptan; 17 had used subcutaneous 
sumatriptan and 8 oral triptans. The main reasons for trying intranasal 
zolmitriptan were: poor tolerability in 12 patients and insufficient efficacy in 
6.
RESULTS: Among the 17 patients experienced in subcutaneous sumatriptan, 12 (71 
%) preferred nasal zolmitriptan, 2 (18 %) subcutaneous sumatriptan and 2 (12 %) 
did not express any preference. The reasons for preferring intranasal 
zolmitriptan were: higher convenience (n = 6), better tolerability (n = 5), 
lower price (n = 2) and higher efficacy (n = 1). Seven out of the 8 patients who 
had taken oral triptans preferred nasal zolmitriptan, in all cases due to higher 
subjective efficacy. A total of 11 patients showed efficacy within 30 minutes. 
Only 3 patients referred to adverse events, always mild.
CONCLUSIONS: The 5 mg nasal formulation of zolmitriptan is a potential new 
option for the symptomatic treatment of cluster headache. This formulation 
should be considered in patients with poor tolerability to subcutaneous 
sumatriptan and in those attacks where quick access to inhaled oxygen is not 
possible. These results suggest that a controlled trial with nasal zolmitriptan 
in this indication would be worthwhile.