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DIHYDROERGOTAMINE NASAL SPRAY FOR MIGRAINE.

In the U.S., ergotamine and related compounds are available in parenteral, oral, and suppository forms to treat migraine. This study examined the efficacy of an intranasal preparation of dihydroergotamine (DHE) in 310 patients with moderate-to-severe migraine headache.

The patients were randomized to use either 2 or 3 mg of DHE nasal spray or placebo. Within 30 minutes, pain relief was significantly greater among patients using the 2 mg dose than among placebo recipients; at 4 hours, the proportion of patients classified as responders (i.e., with no pain or mild pain) was 70 percent with 2 mg of DHE, and only 28 percent with placebo. Only 15 percent of those responding within 4 hours reported recurrent headache within 24 hours. Rhinitis, nausea, and "taste perversion" were the only significant side effects. The 3 mg dose was not superior to the 2 mg dose.

Comment: The response to intranasal DHE appears comparable to that of other migraine treatments. The nasal route overcomes the problem of giving oral drugs to nauseated patients, and avoids the disadvantages of injections. The manufacturer of DHE (which supported this study) hopes that intranasal DHE will be approved for use in the U.S. by late spring of 1997.

— AS Brett

Published in Journal Watch General Medicine January 7, 1997

Citation(s):

Gallagher RM et al. Acute treatment of migraine with dihydroergotamine nasal spray. Arch Neurol 1996 Dec 53 1285-1291.

• Medline abstract (Free)