1Instituto de los Seguros Sociales, Universidad del Valle, Cali, Colombia.
Head Face Med. 2009 Nov 8;5:21. doi: 10.1186/1746-160X-5-21.
Methylergonovine is an ergot alkaloid widely used in postpartum women. It is also an active metabolite of methysergide and previous studies suggest that it could be effective against refractory headache and cluster headache. The purpose of the present study was to assess the potential therapeutic effectiveness of methylergonovine in the emergency treatment of severe migraine.
One hundred and twenty five female patients with migraine attending the emergency department received 0.15 mg of methylergonovine intravenously. Pain intensity, heart rate, blood pressure, and methylergonovine side effects were checked 5, 10, 15, 30 and 60 minutes after drug administration. An additional 0.075 mg dose of methylergonovine was administered to those patients who did not experienced relevant pain relief 15 minutes after dosing.
Pain intensity decreased markedly from the first minutes after dosing, the 74.4% of patients being pain free at 60 minutes. Only seven patients required an additional dose of methylergonovine. Nausea and vomiting were the most relevant side effects related with methylergonovine administration (84% of patients). A substantial decrease (10 to 25 mmHg) in systolic blood pressure values was observed in 56% of the patients. A significant correlation (p < 0.0001) was found between the decrease in pain intensity and the reduction of systolic blood pressure.
Although limited by the non-controlled design of the study, our data suggest that intravenous methylergonovine can be an effective and safe drug in the management of severe migraine attacks in the emergency room.
甲基麦角新碱是一种广泛用于产后妇女的麦角生物碱，也是麦角乙脲的活性代谢物，先前的研究表明它可能对难治性头痛和丛集性头痛有效。本研究的目的是评估甲基麦角新碱在急诊治疗严重偏头痛中的潜在治疗效果。
125 名偏头痛女性患者在急诊室接受 0.15 毫克的甲基麦角新碱静脉注射。在给药后 5、10、15、30 和 60 分钟检查疼痛强度、心率、血压和甲基麦角新碱的副作用。对于那些在给药后 15 分钟没有相关疼痛缓解的患者，给予 0.075 毫克的额外剂量的甲基麦角新碱。
疼痛强度从给药后第一分钟开始显著降低，74.4%的患者在 60 分钟时无疼痛。只有 7 名患者需要额外剂量的甲基麦角新碱。恶心和呕吐是与甲基麦角新碱给药相关的最常见副作用（84%的患者）。56%的患者观察到收缩压值显著下降（10 至 25 毫米汞柱）。疼痛强度的降低与收缩压的降低之间存在显著相关性（p < 0.0001）。
尽管研究设计不受控制，但我们的数据表明，静脉内甲基麦角新碱可以作为急诊室严重偏头痛发作的有效和安全药物。
