Can cigarette smoking worsen the clinical course of cluster headache?

Tiraferri, Ilaria; Righi, Federica; Zappaterra, Maurizio; Ciccarese, Michela; Pini, Luigi Alberto; Ferrari, Anna; Cainazzo, M. M.

doi:10.1186/1129-2377-1-s1-p54

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…Nicotine has been shown to decrease pain sensitivity among smokers and to attenuate emotional distress associated with pain . However, smoking may have minimal positive benefit for CH patients as emerging data reveal that cigarette smokers may, in fact, prolong the active phase of an attack episode compared to nonsmokers (mean 15.1 vs 5.7 weeks; P < .001) and lead to higher pain intensity and poorer pain‐related functioning …”

Section: Discussionmentioning

confidence: 44%

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Clinical Characteristics and Treatment Patterns Among Patients Diagnosed With Cluster Headache in U.S. Healthcare Claims Data

et al. 2017

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ObjectiveTo characterize demographics, clinical characteristics, and treatment patterns of patients with cluster headache (CH).BackgroundCH is an uncommon trigeminal autonomic cephalalgia with limited evidence‐based treatment options. Patients suffer from extremely painful unilateral headache attacks and autonomic symptoms with episodic and chronic cycles.Design/MethodsThis retrospective analysis used insurance claims from Truven Health Analytics MarketScan® research databases from 2009 to 2014. Two cohorts were compared: CH patients (with ≥2 CH claims) were propensity score matched with 4 non‐headache controls, all with continuous enrollment for 12 months before and after the date of first CH claim or matched period among controls.ResultsCH patients (N = 7589) were mainly male (57.4%) and 35‐64 years old (73.2%), with significantly more claims for comorbid conditions vs controls (N = 30,341), including depressive disorders (19.8% vs 10.0%), sleep disturbances (19.7% vs 9.1%), anxiety disorders (19.2% vs 8.7%), and tobacco use disorders (12.8% vs 5.3%), with 2.5 times greater odds of suicidal ideation (all P < .0001). Odds of drug dependence were 3‐fold greater among CH patients (OR = 2.8 [95% CI 2.3‐3.4, P < .0001]). CH patients reported significantly greater use of prescription medications compared with controls; 25% of CH patients had >12 unique prescription drug claims. Most commonly prescribed drug classes for CH patients included: opiate agonists (41%), corticosteroids (34%), 5HT‐1 agonists (32%), antidepressants (31%), NSAIDs (29%), anticonvulsants (28%), calcium antagonists (27%), and benzodiazepines (22%). Only 30.4% of CH patients received recognized CH treatments without opioids during the 12‐month post‐index period. These patients were less likely to visit emergency departments or need hospitalizations (26.8%) as compared to CH patients with no pharmacy claims for recognized CH treatments or opioids (33.6%; P < .0001).ConclusionsThe burden of CH is associated with significant co‐morbidity, including substance use disorders and suicidal ideation, and treatment patterns indicating low use of recognized CH treatments.

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Section: Discussionmentioning

confidence: 44%

“…This is consistent with other findings that have found smoking to be frequent and extensive in CH patients . Approximately 90% of CH patients have a reported prolonged history of tobacco use . The link between smoking and CH is likely a coping strategy to reduce the severe pain.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Treatment Patterns Among Patients Diagnosed With Cluster Headache in U.S. Healthcare Claims Data

et al. 2017

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“…Studies indicated that a vast majority of those patients had started smoking before the onset of CH . Current smokers suffering from CH have reported prolonged pain periods and more frequent peaks in 1 day compared with nonsmokers . The clinical CH phenotype in tobacco smokers appears to be more severe, based on attack frequency, cycle duration, and headache‐related disability.…”

Section: Discussionmentioning

confidence: 99%

Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

et al. 2019

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Objective To describe a case series of 7 patients presenting cluster headache (CH) criteria and a substance use disorder, reported to a French Addictovigilance center. Then, to assess clinical, pharmacological, and neurobiological linkages between substance use and CH onset. Background CH patients are presenting a higher prevalence of comorbidities, among which the use of psychoactive substances, licit or illicit, have been explored by a few authors. Recently, 3 cases of CH in patients seen in the hospital‐based addiction care center have been reported to the Toulouse addictovigilance center. Methods Other cases have been identified in the same tertiary hospital after a collaborative investigation done with the departments of neurology and psychiatry and included in the case series. A narrative review was performed to assess the potential of psychoactive substance consumption to induce or facilitate CH. Results From 2016 to 2018, 6 males and 1 female aged between 26 and 54 years old, presenting CH criteria and a substance use disorder, were included in our case series. Among substances used, there are: (1) daily use of tobacco and alcohol in 5/7 subjects; (2) daily or almost daily use of cocaine in 5/7 subjects; (3) regular use of cannabis before attacks beginning in 4/7 subjects; and (4) opioids, as a substitutive medication or abused, in 5/7 subjects. The intranasal route administration is reported by all the subjects and precedes the beginning of attacks for 5/7 subjects. Conclusions We have found a CH prevalence of 0.9% in our studied population, while it is estimated at 0.1% in the general population. The coexistence of cluster headache and addiction behaviors reflects possible common neurobiological pathways, which would include the hypothalamus. Research could be conducted on the potential of hypothalamic therapeutic targets.

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Can cigarette smoking worsen the clinical course of cluster headache?

Cited by 2 publications

References 3 publications

Clinical Characteristics and Treatment Patterns Among Patients Diagnosed With Cluster Headache in U.S. Healthcare Claims Data

Clinical Characteristics and Treatment Patterns Among Patients Diagnosed With Cluster Headache in U.S. Healthcare Claims Data

Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

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