Management of Ergotamine Withdrawal

Abstract

Excessively frequent use of ergotamine is known to produce a number of complications which interfere with the effective management of patients with chronic recurrent headaches. It is known to produce malaise, nausea and, above all, increased frequency of headache (Lippman 1955; Saper 1967; Rose and Wilkinson 1976), and subsequently a predictable daily or near daily headache syndrome (Mathew et al. 1982). The therapeutic range becomes progressively narrower with long-term usage of ergotamine. Chronic abuse of ergotamine also produces ergotism which has a number of manifestations including involvement of the cardiovascular system, apparently secondary to arterial spasm in the major arterial territories, especially in the limbs; and neurological manifestations such as confusion, psychosis, convulsions, drowsiness, hemiplegia and peripheral neuropathy (Hokkanen et al. 1978; Horton and Peters 1982).