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Repetitive intravenous dihydroergotamine as therapy for intractable migraine

University of California, San Francisco, School of Medicine, San Francisco, CA.

For patients with chronic intractable headache, we compared a new treatment and a traditional one. Fifty-five patients (36 dependent on ergotamine, analgesics, diazepam, or corticosteroids) were given IV dihydroergotamine (DHE) and metoclopramide every 8 hours. Fifty-four age- and sex-matched patients (38 drug-dependent) were given diazepam intravenously every 8 hours. Forty-nine of the 55 DHE-treated patients became headache-free within 48 hours, and 39 of them sustained benefits in a mean follow-up of 16 months. In contrast, 7 diazepam-treated patients became free of headache within 3 to 6 days, and 31 had improved somewhat in 10 days. Repetitive IV DHE helps to terminate cycles of intractable migraine.

Address correspondence and reprint requests to Dr. Raskin, University of California, San Francisco, School of Medicine, San Francisco, CA 94143.

Accepted for publication November 6, 1985.

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