Brain, Vol. 123, No. 1, 9-18,
January 2000
© 2000 Oxford University Press
Review Article |
Ergotamine in the acute treatment of migraine
A review and European consensus
1 Department of Neurology, Glostrup Hospital, Copenhagen, Denmark, 2 Department of Pharmacology, Erasmus University Medical Centre, Rotterdam, 3 Department of Neurology, Leiden University Medical Centre, The Netherlands, 4 Gothenburg Migraine Clinic, Göteborg, Sweden, 5 Service of Neurology, University Hospital Marqués de Valdecilla, Santander, 6 Hospital General Universitario, Valencia, Spain, 7 CHU Hospital Pellegrin Service de Neurologie, Bordeaux, France, 8 Neurologische Klinik and Poliklinik, University of Essen, Germany, 9 Departments of Neurology and Neuroanatomy, University of Liege, Belgium, 10 The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
Correspondence to:
Professor Peter J. Goadsby, Institute of Neurology, Queen Square, London WC1N 3BG, UK E-mail: peterg{at}brain.ion.ucl.ac.uk
Ergotamine has been used in clinical practice for the acute treatment of migraine for over 50 years, but there has been little agreement on its place in clinical practice. An expert group from Europe reviewed the pre-clinical and clinical data on ergotamine as it relates to the treatment of migraine. From this review, specific suggestions for the patient groups and appropriate use of ergotamine have been agreed. In essence, ergotamine, from a medical perspective, is the drug of choice in a limited number of migraine sufferers who have infrequent or long duration headaches and are likely to comply with dosing restrictions. For most migraine sufferers requiring a specific anti-migraine treatment, a triptan is generally a better option from both an efficacy and side-effect perspective.
migraine; headache; acute treatment; serotonin pharmacology; 5-HT IB/1D receptors
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