The purpose of this study is to test the effects of sodium oxybate on headache response (frequency), sleep quality and quality of life in the prophylactic treatment of patients with chronic and episodic cluster headache. Oral sodium oxybate, 3-9g per night, starting with 3g in two nightly dosages of 1.5g and increased by steps of 1.5g every second or third night until treatment Response will be evaluated in an interventional, placebo-controlled, double-blind, randomised, parallel group, multicentre study. Primary outcome is reduction of nocturnal pain frequency Secondary outcomes are improvement of sleep quality at a subjective level as assessed by diary and standardized scales (PSQI, FOSQ), duration of pain free episodes, general clinical outcome (global evaluation), clinical global impression (CGI-S, CGI-I, CGI-E), quality of life (SF 36) and daytime sleepiness (Epworth Sleepiness Score).
Multicenter study to test the safety and efficacy of sodium oxybate in the prophylaxis of headache and sleep disturbances in patients with chronic and episodic cluster headache using a placebo-controlled, double blind, randomized study, parallel group design. Patients with predominant nocturnal attacks and poor sleep quality will be evaluated; At least 1 attack every other day and at least 8 attacks cumulatively by the time prior to randomization are required. Sodium oxybate will be orally administered, 3-9g per night, starting with 3g in two nightly dosages of 1.5g (the first at bedtime and the second 4 hours later). Dosage will be gradually increased by steps of 1.5g every second night until treatment response during a titration period of 14 days. Effects od sodium oxybate will be monitored via pain and sleep diaries during a 14 days stable treatment phase by reviewing sleep/pain diaries and Quality of life assessement. Primary outcomes are frequency of nocturnal pain attacks; Main secondary outcomes are frequency, intensity and duration of daytime pain attacks, improvement of sleep quality, quality of life, duration and rates of pain free episodes, decrease in escape medication for acute headache attacks (use of triptans). Safety parameters are ECG, laboratory, depressions scales, vital signs, respiratory polygraphy. Intent-to treat analysis, multivariate analysis of variance (MANOVA) with depending variable (reduction of pain frequency and pain intensity of nocturnal attacks) and the co-variates (age, sex , chronic vs. episodic CH).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
parallel Group administration
parallel Group administration
nocturnal pain frequency as assessed by patients reports
Reduction of nocturnal pain frequency as documented in patients diary,
Time frame: 4 weeks
Improvement of sleep quality
Change assessed by PSQI (Pittsburgh Sleep Quality Inventory)
Time frame: 4 weeks
pain free time as assessed by diary
number and duration of pain free time periods compared to baseline
Time frame: 4 weeks
Clinical Global Impression
Change assessed by CGI-E scale
Time frame: 4 weeks
Quality of life
Assessed by SF 36
Time frame: through study completion
Daytime Sleepiness
Improvement as assessed by Epworth Sleepiness Score
Time frame: 4 weeks
Escape medication
Decrease in escape medication for acute headache attacks (use of triptans)
Time frame: 4 weeks
Depression
Change in Beck's depression inventory (BDI-II)
Time frame: 4 weeks
Functional outcome of sleep quality
Changes as assessed by questionaire of Functional Outcomes of Sleep Questionaire (FOSQ)
Time frame: 4 weeks
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