VALLEY DOCTOR FINDS NOSE SPRAY OFFERS FAST RELIEF FROM MIGRAINES.

Byline: Jeanne Mariani-Belding Daily News Staff Writer

As a teen-ager, Dr. Morris Maizels remembers his vision blurring moments before the excruciating attack of a migraine headache, the pain so intense it made him sick to his stomach.

Those painful headaches, which he still occasionally endures, helped inspire the Kaiser Permanente physician in Woodland Hills to conduct a study on a treatment for migraines that has uncovered the fastest and safest relief documented to date using a painkiller called lidocaine.

Maizels' findings, published today in the The Journal of the American Medical Association, showed 55 percent of the migraine sufferers who used lidocaine nose drops felt better within just 5 to 15 minutes, compared with 21 percent of patients given a placebo made of saltwater.

``There's no other headache drug that works this quickly and is free of side effects. Other headache drugs cause sedation, nausea and some of them have warnings that say patients with heart conditions and circulatory conditions cannot take them. This drug is very safe,'' said Maizels, a family practitioner who also treats headache patients by referral.

Side effects of the lidocaine treatment can include burning, stinging or numbness in the nose or eye area, said Maizels, who has been treating patients at Kaiser for 13 years.

At about a nickel a dose, the new treatment would cost much less than other migraine pain relievers now available, which typically costs up to $10 a pill or $35 per injection, according to Maizels.

Lidocaine is the drug dentists inject patients with before performing major procedures, such as root canals, and also can be found in small doses in topical sunscreens and in other over-the-counter products.

The preliminary findings are encouraging news for the 17 percent of women and 6 percent of men who suffer from migraines. Migraines, a type of severe headache, can occur anywhere from once a year to once a week and can last up to three days, Maizels said.

``Patients with migraines sometimes have headaches so severe they cannot function and it's clear they are in misery,'' said Maizels, who has tried lidocaine nose drops on his own migraines with successful results.

Lidocaine nose drops have been used to effectively treat cluster headaches - another kind of malady - since 1980s by prescription, which led Maizels to study its effects on migraines in a two-year controlled study.

Maizels' study of 81 migraine sufferers - all of them urgent care patients at Kaiser's Woodland Hills medical center - found that of the 53 patients given lidocaine nose drops, 29 said their symptoms had diminished by at least 50 percent within five to 15 minutes.

In tracking 24 of those patients over a 24-hour period, 58 percent reported that the pain did not return, according to Maizels. But the pain did return for the others, usually within just one hour.

``I think the relapse factor is a major concern, but it should be put in context that all prescription medication for migraines have at least a 40 percent relapse rate,'' he said.

Early reaction to Maizels' study has been positive.

Dr. Alan M. Rapaport, director of the New England Center for Headache in Stamford, Conn., told the Associated Press that the information was impressive.

``Relief in five minutes is dramatic, almost unbelievable. Clearly, this is a very important study,'' said Rapaport, who was not involved in the study.

While the study's findings are encouraging, Maizels said more tests must be done before the treatment can be made available to the public.

``I think we need other researchers to study several hundred patients and we need to be able to show that patients can use this at home on their own an that they can continue to get relief after several headache attacks. Our study just focused on single headaches,'' he said.

``If our study results can be repeated then our drug would be a major advance in the therapeutic option for migraines,'' Maizels said.

Maizels, 44, a Woodland Hills resident, received his medical degree from the University of Washington in Seattle. He did his undergraduate work at the University of California, Los Angeles, and at UC Berkeley.