Recurrent ergotism: a case report.

A patient was seen with absent pulses and vague symptoms. History and clinical findings supported a diagnosis of ergotism due to heavy use of ergotamine suppositories. The patient continued to use ergotamine despite warnings and was seen on two additional occasions with ergotism. Previously a heavy user of ergotamine, she became sensitive to small doses, demonstrating marked vasospasm after only one suppository. This phenomenon, not previously reported, is postulated secondarily to drug interaction. The patient is presented with a review of the pharmacology, toxicity, and treatment of ergotamine-induced ergotism. Alerted to the possibility of drug interactions, physicians may safely use ergotamine in the treatment of migraine headache with careful monitoring for signs and symptoms of early toxicity.