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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, nau…