Ergotamine Tartrate Dependency: Possible Mechanisms

Abstract

For over 50 years, ergotamine tartrate (ET) has been considered the drug of first choice for an acute attack of migraine. Estimated effectiveness occurs in up to 90% of instances when the drug is used parenterally, 80% rectally, and in 50% orally (Dalessio 1980). ET has a stimulating effect on smooth muscle which produces vasoconstriction, an effect on medullary tissues causing a sympatholytic reaction, and a peripheral alpha-adrenergic blocking action (Rail and Schleifer 1980). Although assumed historically to be related to vasoconstriction, the specific influence of ET on migraine is not known with absolute certainty. Early reports by Dalessio et al. (1961) and more recent work by this author (Saper and van Meter 1980; Saper 1983; Saper and Jones 1986) have raised the possibility that the mechanism by which ergot derivatives affect migraine may be by both central as well as peripheral effects.KeywordsChronic HeadacheCortisol SecretionErgot AlkaloidDexamethasone Suppression TestLocus CeruleusThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.