Ergotamine is a well known pharmacological remedy applied in neurology (treatment of
vascular headache) and in obstetrics (abortive remedy, uterus atony). But today it is rarely used, because of new safer anti-
migraine medicine (triptanes) which cause fewer side effects. According to obstetrical indications
ergotamine is applied only in hospital treatment. For that reason, cases of intoxication by this class of drugs are rarely observed.
Ergotamine causes constriction of the blood vessels through the blockade of alpha-receptors and stimulation of the
serotonin-receptors on the walls of blood vessels both in the central nervous system and in peripheral circulation. Intoxication/overdose symptoms may appear on application of therapeutic dose by sensitive patients, mostly by patients with
migraine headache using
ergotamine preparation for relief of
migraine attacks. In the Regional Centre of Clinical Toxicology, a 21-year-old patient was hospitalized. She took about 20
tablets of
Cafergot (complex preparation containing 1mg
ergotamine tartare and 100mg
caffeine). During her stay on the ward, typical symptoms of severe
poisoning were observed:
nausea, severe
vomiting,
dizziness, decreased blood pressure without perceptible pulse, narrowing of the blood vessels in the extremities of the body (peripheral vasoconstriction) -
paresthesia, digital
cyanosis, refrigeration of legs, angina. Due to taking once of a great dose of the
drug by the patient, violent process of intoxication, possibility of dangerous complication and also the unavailability of specific antidotes and lack of efficient methods of extracorporeal elimination of the
drug, the patient was intensively controlled and symptomatic treatments according to the law of intensive
therapy was applied.