A Double Blind Trial with Dihidroergotamine Spray in Migraine Crisis

Paiva, Teresa; Esperança, Paula; Marcelino, Luís; Assis, Gentil

doi:10.1177/03331024850050s349

Cited by 10 publications

(11 citation statements)

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“…In Gallagher's study, 96 the incidence of the most commonly reported adverse events was slightly higher with a 3‐mg dose of DHE than with a 2‐mg dose. The only trial that permitted patients to administer up to 4 mg of DHE did not report any detailed information about adverse events 90 . The rate of adverse events was similar to that observed with Cafergot in 1 comparative study and significantly lower than that observed with SC sumatriptan in another.…”

Section: Intranasal Dihydroergotaminementioning

confidence: 73%

“…Nine trials included comparisons of DHE nasal spray with placebo for the acute treatment of migraine. Three of these trials tested 2 different doses of DHE against placebo 88‐90 . One trial compared DHE nasal spray with the proprietary formulation, 70 Cafergot (E 1 mg plus caffeine 100 mg), and one compared DHE with SC sumatriptan 91 .…”

Section: Intranasal Dihydroergotaminementioning

confidence: 99%

“…Four of the above comparisons with placebo provided effect size estimates suitable for meta‐analysis 90,92‐94 . We chose the effect size for the higher dose of DHE (1 to 4 mg) in the Paiva et al study, 90 because that dose was closer to the doses used in the other trials.…”

Section: Intranasal Dihydroergotaminementioning

confidence: 99%

“…Three of these trials tested 2 different doses of DHE against placebo. [88][89][90] One trial compared DHE nasal spray with the proprietary formulation, 70 Cafergot (E 1 mg plus caffeine 100 mg), and one compared DHE with SC sumatriptan. 91 In general, however, doses and treatment protocols used in the 9 placebo-controlled trials were generally similar, so that results should be comparable across trials.…”

Section: Intranasal Dihydroergotaminementioning

confidence: 99%

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Ergotamine and Dihydroergotamine: History, Pharmacology, and Efficacy

2003

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Ergotamine and dihydroergotamine share structural similarities with the adrenergic, dopaminergic, and serotonergic neurotransmitters. As a result, they have wide-ranging effects on the physiologic processes that they mediate. Ergotamine and dihydroergotamine are highly potent at the 5-HT1B and 5-HT1D antimigraine receptors and, as a consequence, the plasma concentrations that are necessary to produce the appropriate therapeutic and physiologic effects are very low. The broad spectrum of activity at other monoamine receptors is responsible for their side effect profile (dysphoria, nausea, emesis, unnecessary vascular effects). Both ergotamine and dihydroergotamine have sustained vasoconstrictor actions. In acute migraine treatment, their mechanisms of action involve constricting the pain-producing intracranial extracerebral blood vessels at the 5-HT1B receptors and inhibiting the trigeminal neurotransmission at the peripheral and central 5-HT1D receptors. The scientific evidence for efficacy is stronger for dihydroergotamine than for ergotamine. Their wide use is based on long-term experience.

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Section: Intranasal Dihydroergotaminementioning

confidence: 73%

Section: Intranasal Dihydroergotaminementioning

confidence: 99%

Section: Intranasal Dihydroergotaminementioning

confidence: 99%

Section: Intranasal Dihydroergotaminementioning

confidence: 99%

See 2 more Smart Citations

Ergotamine and Dihydroergotamine: History, Pharmacology, and Efficacy

2003

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“…The efficacy of DHE as a prophylactic interval treatment of migraine was reported as early as 1946 and has been confirmed by many investigators (1). Recently, DHE nasal spray, a new galenic form, has been used for the acute treatment of migraine attacks (2)(3)(4)(5).…”

mentioning

confidence: 99%

Dihydroergotamine Nasal Spray During Migraine Attacks: A Double-Blind Crossover Study with Placebo

et al. 1987

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Ergot derivatives have been used in the treatment of migraine for more than 50 years. We have compared the efficacy of dihydroergotamine (DHE) nasal spray with that of placebo in patients with classic or common migraine attacks. The study was performed in accordance with a double-blind, crossover design. In this study a great placebo effect was observed with a dose of 1.36 mg/attack, and the overall efficacy was rated by the patients to be 41% and 52% for placebo and DHE, respectively.

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Recent advances in the acute management of migraine and cluster headaches

Kumar

1994

J Gen Intern Med

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I have discussed the pharmacokinetics, efficacies, and side effects of the various nonnarcotic drugs available for the treatment of patients who have headache. Sumatriptan, the newest one, is expensive but may be cost-effective for those who have failed traditional migraine treatment, who visit the ER frequently, who have potential for drug abuse, or who have to miss time from school or work due to the headache. Studies are in progress to compare sumatriptan with other available drugs such as DHE-45 and to determine its possible role in the prophylaxis of migraine. A new 5-HT1D receptor agonist with more efficacy and fewer side effects may be developed in the future. When sumatriptan and DHE-45 are contraindicated due to hypertension or coronary artery disease, other drugs such as metoclopramide, ketorolac, and butorphanol can be used as alternatives.

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A Double Blind Trial with Dihidroergotamine Spray in Migraine Crisis

Cited by 10 publications

References 0 publications

Ergotamine and Dihydroergotamine: History, Pharmacology, and Efficacy

Ergotamine and Dihydroergotamine: History, Pharmacology, and Efficacy

Dihydroergotamine Nasal Spray During Migraine Attacks: A Double-Blind Crossover Study with Placebo

Recent advances in the acute management of migraine and cluster headaches

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