Abstract | BACKGROUND: METHODS: A total of 31 patients fulfilling ICHD-II criteria for chronic daily headache, 25 with chronic migraine and 6 with medication overuse headache, were treated with outpatient home-based continuous intravenous dihydroergotamine for 3 days. Patients were pretreated with 10 mg intravenous metoclopramide prior to the first day of infusion and administered 3 mg dihydroergotamine given continuously at a rate of 42 mL/hour on day 1 and 2, and administered 1.5 mg on day 3 at the rate of 21 mL/hour. The primary end point was a change in pain intensity, as measured by an 11-point numeric pain intensity scale at the end of 3 days. The secondary end point was reduction in headache frequency at long-term follow-up. RESULTS: Patients reported an average of 63.4% reduction in the intensity of migraine pain by the end of the 3-day infusion. Side effects were minimal and no serious adverse effects occurred. Approximately one-third of patients became completely headache-free after day 3, and 1 patient had no improvement. Long-term follow-up data indicated an average 86% reduction in headache frequency and almost every patient converted from chronic daily headache to episodic migraine except for 1 patient. Patients with medication overuse headache were no longer consuming the daily offending medication. CONCLUSIONS: Efficacy and safety of our outpatient home-based intravenous dihydroergotamine program compared favorably to that of established inpatient intravenous pulse injection and continuous infusion protocols for the treatment of intractable migraine. The use of outpatient continuous intravenous dihydroergotamine is an effective and well-tolerated therapy for intractable migraine but without the added cost and inconvenience of hospitalization.
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Authors | James A Charles, Patricia von Dohln |
Journal | Headache
(Headache)
Vol. 50
Issue 5
Pg. 852-60
(May 2010)
ISSN: 1526-4610 [Electronic] United States |
PMID | 20132337
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Analgesics, Non-Narcotic
- Dihydroergotamine
|
Topics |
- Adolescent
- Adult
- Analgesics, Non-Narcotic
(administration & dosage)
- Dihydroergotamine
(administration & dosage)
- Female
- Headache Disorders
(drug therapy)
- Home Infusion Therapy
(methods)
- Humans
- Infusions, Intravenous
- Male
- Migraine Disorders
(drug therapy)
- Pain, Intractable
(drug therapy)
- Prospective Studies
- Young Adult
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