Saper J R, Jones J M
Clin Neuropharmacol. 1986;9(3):244-56. doi: 10.1097/00002826-198606000-00003.
Based on our clinical experience and the data reviewed and presented in this report, we propose that a state of physical dependency to ergotamine tartrate exists. This dependency state is characterized by the irresistible and dependable use of ergotamine tartrate and is contingent upon a self-sustaining, rhythmic headache/medication cycle that reflects the dependency. The headache and accompaniments (withdrawal headache?) represent the primary withdrawal symptoms. The presence of this state appears to render patients refractory to other forms of preventative therapy, which can be effective only when ergotamine is discontinued and the cycle broken. If the condition is left untreated, it is likely though by no means certain that the more traditional aspects of ergotism will evolve, although variable susceptibility and tolerance to ergotamine tartrate have been demonstrated. The mechanism of this disorder remains uncertain but might be related to the influence of ergotamine tartrate on the limbic-hypothalamic-pituitary-adrenal axis and other aminergic centers (locus ceruleus), areas considered by some as the central loci for the pathogenesis and associated symptoms of migraine.
基于我们的临床经验以及本报告中回顾和呈现的数据，我们提出存在对酒石酸麦角胺的身体依赖状态。这种依赖状态的特征是对酒石酸麦角胺的不可抗拒且持续的使用，并且取决于反映这种依赖的自我维持、有节律的头痛/用药周期。头痛及伴随症状（戒断性头痛？）代表主要的戒断症状。这种状态的存在似乎使患者对其他形式的预防性治疗无效，只有在停用酒石酸麦角胺并打破这个周期时，这些治疗才会有效。如果这种情况不治疗，虽然并非肯定，但麦角中毒的更传统方面可能会发展，尽管已证明对酒石酸麦角胺存在易感性和耐受性差异。这种病症的机制仍不确定，但可能与酒石酸麦角胺对边缘 - 下丘脑 - 垂体 - 肾上腺轴以及其他胺能中心（蓝斑）的影响有关，一些人认为这些区域是偏头痛发病机制和相关症状的中心部位。
