Pioneer pill that relieves ‘suicide headache’ agony

SUFFERERS of the agonising ‘suicide headache’ condition trigeminal neuralgia are being offered hope by a new drug that blocks pain transmission. There is no cure for the condition, and until now it has been largely treated with anti-epileptic drugs.

While these dampen the excruciating pain, they have a range of side effects and can affect cognition, memory and the ability to speak.

The new drug, which is still on trial, is the first specifically designed for trigeminal neuralgia. A UK study published last month showed a 30 per cent reduction in pain levels for patients.

Unlike the epilepsy drugs, which affect the whole brain system, the drug specifically targets pain communication from the trigeminal nerve.

Facial pain specialist Professor Joanna Zakrzewska, of the Eastman Dental Hospital, part of the University College London Hospital Foundation NHS Trust, led the trial on the new drug – codenamed BIIB074.

She said: ‘ This new drug doesn’t affect the rest of the brain as the epilepsy drugs do because it was created just for trigeminal neuralgia.

‘The results are very encouraging and we think it will eventually become licensed and available to patients within three to four years.’

The illness is diagnosed in approximately 8,000 Britons every year in the UK.

They experience sudden, shooting pain in the cheeks, jaw and forehead which can last from a few seconds to a couple of minutes.

Some patients suffer up to 100 attacks a day, and the severity and unrelenting nature of the pain has led to sufferers taking their own lives.

Nine in every ten cases are thought to be caused by a blood vessel pressing on the trigeminal nerve, the large, threebranch nerve transmitting sensations of pain and touch from the face, teeth and mouth to the brain.

Over time, the pressure from the blood vessel wears away the protective coating around the nerve – the myelin sheath – which explains why it often emerges in people over 50.

Attacks can be triggered by everyday tasks such as shaving, showering, brushing teeth or even talking.

Explaining why trigeminal neuralgia is often linked to suicide, Prof Zakrzewska added: ‘Patients can have series of attacks – often up to 50 or more in a day – which can last for days, and then they can have quite long periods of remission.

‘Others can have pain that is always with them. Life can be depressing and exhausting.’

PROFESSOR Hugh Coakham, a neurosurgeon in Bristol and an expert in the condition, said: ‘ The condition mostly affects middle-aged and older people. This may be because blood vessels become gnarled and twisted with age, encroach over the nerve and wear down the insulating sheath.’

Prof Zakrzewska’s stage two trial with BIIB074 involved 29 patients from the UK and abroad. Details of the trial are published in the medical journal Lancet Neurology.

The company behind the drug is now planning a larger stagethree trial which would allow it to apply for a licence to market the drug.