This study investigated the efficacy of
methylergonovine maleate (
Methergine) in the treatment of
drug induced refractory
headache (DIRH). Sixty consecutive patients (51 female and 9 male) diagnosed with DIRH were treated with
methylergonovine maleate for a maximum of six months, using a within subject design. All patients were withdrawn from the medications they were taking upon entering the study. Concurrently, they were given 0.2-0.4 mg of
methylergonovine maleate three times a day. Patients were provided the means to control breakthrough episodes of
headache. Treatment outcome was assessed using a patient self-report scale (much better, better, same, worse, and much worse), and also visual analogue
pain intensity scales. The side effects of the
drug were assessed with patient self-report.
Methylergonovine was effective in 44 (73%) patients. Twelve (20%) patients reported unchanged
pain and 4 (6%) patients got worse. Side effects were reported by 24 patients. These were predominantly abdominal cramping. It is concluded that
methylergonovine maleate is effective in the initial control of
drug induced refractory
headache. However, because
methylergonovine is a metabolic byproduct of
methysergide, the possibility or fibrotic disorders needs to be considered if
methylergonovine is to be used for long term
therapy.