Treatment of Headache with Ergotamine‐Caffeine Suppositories

Magee, K R; Westerbert, M R; Dejong, R

doi:10.1212/wnl.2.11-12.477

Cited by 6 publications

(1 citation statement)

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“…Horton and colleagues [16] reported "excellent" results with the open-label use of oral combined ET, 1 mg, and caffeine, 100 mg, in 10 of 14 patients [16]. A subsequent open trial of combined ET, 2 mg, and caffeine, 100 mg, reported a considerably lower response rate in 4 of 20 patients [17]. Caffeine was added to these preparations to enhance absorption and potentiate analgesia.…”

Section: Ergot Derivativesmentioning

confidence: 99%

Serotonergic Agents in the Management of Cluster Headache

Lambru

Matharu

2011

Curr Pain Headache Rep

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Cluster headache is a highly disabling primary headache disorder, characterized by unilateral headache attacks occurring in association with cranial autonomic symptoms. Serotonergic agents, such as the ergot alkaloids, have traditionally been used for the acute and preventive treatment of cluster headache and other primary headaches. Although it initially was thought that their efficacy was due solely to the vasoconstriction of extracranial cerebral vessels, new mechanisms of action of these drugs have been ascertained as a consequence of advances in elucidation of the pathogenesis of primary headaches and the development of triptans. This article reviews the current knowledge about serotonergic agonists and antagonists used in the management of cluster headache, focusing on their mechanisms of action and on the possible role of serotonin system dysfunction in this complex disorder.

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Section: Ergot Derivativesmentioning

confidence: 99%

Serotonergic Agents in the Management of Cluster Headache

Lambru

Matharu

2011

Curr Pain Headache Rep

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Cluster headache: symptomatic treatment

Torelli

Manzoni

2004

Neurol Sci

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The clinical management of cluster headache (CH) attacks requires a symptomatic treatment that is rapidly effective in resolving or significantly reducing symptoms. First-choice drugs for the symptomatic treatment of CH are subcutaneous sumatriptan at a dose of 6 mg and 100% oxygen inhalation at a rate of 7 l/min for no more than 15 min. Sumatriptan acts by suppressing pain and the accompanying autonomic phenomena, with no substantial differences in its mechanism of action between episodic and chronic CH. The drug can be used for prolonged periods without loss of efficacy or safety and its side-effects are generally mild or moderate. Oxygen inhalation has a number of advantages over drug therapy: it is free from side-effects, has no contraindications--unlike sumatriptan, it can be used in patients with cardiac, cerebral or peripheral vascular disease and with kidney, liver or lung disease--acts rapidly and can be administered several times a day. Its disadvantages are that it is scarcely practical and may induce a "rebound effect". Sumatriptan nasal spray, zolmitriptan and dihydroergotamine nasal spray are scarcely effective. After the introduction of sumatriptan, ergotamine tartrate has been relegated to a secondary role in the symptomatic treatment of CH. Among other non-drug and topical drug treatment options, hyperbaric oxygen therapy and the intranasal application of 10% cocaine hydrochloride and 10% lidocaine in the sphenopalatine fossa have also proved effective.

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Italian guidelines for primary headaches: 2012 revised version

et al. 2012

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The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version.

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Treatment of Headache with Ergotamine‐Caffeine Suppositories

Cited by 6 publications

References 0 publications

Serotonergic Agents in the Management of Cluster Headache

Serotonergic Agents in the Management of Cluster Headache

Cluster headache: symptomatic treatment

Italian guidelines for primary headaches: 2012 revised version

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