Where is dihydroergotamine mesylate in the changing landscape of migraine therapy?

  title={Where is dihydroergotamine mesylate in the changing landscape of migraine therapy?},
  author={John Anthony Morren and Néstor Gálvez-Jiménez},
  journal={Expert Opinion on Pharmacotherapy},
  pages={3085 - 3093}
Importance of the field: Migraine affects approximately 18% of women and 6% of men, and has an immense impact on quality of life and productivity. Advancement in therapeutic options has been slow. For many patients with difficult-to-treat migraine, the appropriate use of dihydroergotamine mesylate (DHE) can result in treatment success and unprecedented patient satisfaction. Areas covered in this review: Migraine treatment guidelines regarding the role of DHE are highlighted. An overview of the… 

Dihydroergotamine (DHE) – Is there a place for its use?

Most clinical data confirm that the drug is still an important element of contemporary migraine therapy, especially in cases when conventional medicine fails, and its role in modern therapy based on available clinical trials is confirmed.

MAP0004: dihydroergotamine mesylate inhalation aerosol for acute treatment of migraine

Both Phase II and III clinical trials support anti-migraine efficacy with superior tolerability withMAP0004 compared with intravenous DHE, and the future use of MAP0004 as a first-line acute migraine treatment is supported.

Intravenous Dihydroergotamine Therapy for Pediatric Abdominal Migraines

DHE may be a treatment option in children with intractable abdominal migraine after being used when other agents like amitriptyline, verapamil, topiramate, or depakote had proved ineffective.

Dihydroergotamine: A Review of Formulation Approaches For the Acute Treatment of Migraine

Among parenteral formulations (including subcutaneous, intramuscular, intravenous and nasal spray), efficacy is superior with injectable dosing, but there are no head-to-head comparisons with triptans available for review.

The pathophysiological and pharmacological basis of current drug treatment of migraine headache

  • D. Reddy
  • Medicine
    Expert review of clinical pharmacology
  • 2013
There are several agents for prevention of migraine occurrence in patients with frequent or severe disabling migraine attacks and new drugs with improved efficacy and reduced side effects are needed for effective treatment and Prevention of migraine.

Delivery of Dihydroergotamine Mesylate to the Upper Nasal Space for the Acute Treatment of Migraine: Technology in Action.

Precision Olfactory Delivery technology may have the potential to overcome the limitations of traditional nasal delivery systems, while utilizing the nasal delivery benefits of GI tract avoidance, rapid onset, patient convenience, and ease of use.

Dihydroergotamine mesylate‐loaded dissolving microneedle patch made of polyvinylpyrrolidone for management of acute migraine therapy

  • C. TasJ. Joyce M. Prausnitz
  • Medicine
    Journal of controlled release : official journal of the Controlled Release Society
  • 2017


Migraine may bring a suffering phase in an individual's schedule yet it can be handled with the familiarity of some self-care remedies and by making simple modifications in the routine lifestyle, which may facilitate to pave the clear way to recovery and make things easier for migraine management.

Current Approach to Undifferentiated Headache Management in the Emergency Department

Antidopaminergics have an established role in the management of acute, severe, headache with manageable side-effect profiles, however, recent studies suggest anesthetic and anti-epileptic drugs may play roles in headache treatment in the ED.

Development and in vitro/in vivo evaluation of dihydroergotamine mesylate loaded maltodextrin-pullulan sublingual films

It is suggested that the polymer combinations of pullulan and maltodextrin formed successful films and were considered as an alternative dosage form for DHE in migraine therapy.



Appropriate use of ergotamine tartrate and dihydroergotamine in the treatment of migraine: current perspectives.

  • W. Young
  • Medicine, Psychology
  • 1997
Clinical practice guidelines were formulated and found ergotamine tartrate and DHE were found to be safe and effective for the treatment of migraine as long as recommended dosages are not exceeded and high-risk patients such as those with uncontrolled hypertension, coronary or peripheral artery disease, thyrotoxicosis, or sepsis do not receive these compounds.

Safety and Efficiency of Ergotamine Tartrate and Dihydroergotamine in the Treatment of Migraine and Status Migrainosus.

The background information for the Practice Parameter is provided, and the appropriate use of ergotamine tartrate and DHE in the treatment of (1) migraine and (2) status migrainosus is defined.

Pharmacology of Dihydroergotamine and Evidence for Efficacy and Safety in Migraine

DHE is a significantly less potent arterioconstrictor than isET, which makes it a potentially much safer drug, and is associated with a markedly lower incidence of medication‐withdrawal headache, nausea, and vomiting than is ET.

Acute treatment of migraine with dihydroergotamine nasal spray. Dihydroergotamine Working Group.

Self-administration of dihydroergotamine resulted in significant increases in pain relief and functional ability and significant decreases in pain intensity and nausea compared with the placebo and the present results suggest that intranasal administration of diHydroergOTamine represents an important new therapeutic option for migraine sufferers.

Acute Treatment of Migraine With Dihydroergotamine Nasal Spray

Self-administration of dihydroergotamine resulted in significant increases in pain relief and functional ability and significant decreases in pain intensity and nausea compared with the placebo, and the present results suggest that intranasal administration of di dehydration represents an important new therapeutic option for migraine sufferers.

Ergotamine tartrate and dihydroergotamine mesylate: safety profiles.

Both DHE and ET are safe and effective when used in recommended doses, and nearly 50 years of clinical experience without major safety problems allows a high level of confidence in their clinical use.

Practical approaches to migraine management.

Recently published evidence-based guidelines advocate migraine-specific drugs, such as serotonin 5-HT(1B/1D) agonists and dihydroergotamine mesylate, for patients experiencing moderate to severe migraine attacks, and additional headache attack therapy options include other ergotamine derivatives.

In-Patient Treatment of Chronic Daily Headache Using Dihydroergotamine: a Long-term Follow-up Study

The results confirm that the DHE protocol is helpful in breaking the cycle of CDH, although the long-term outcomes of this study are more conservative than other studies have reported.

History of the Use of Ergotamine and Dihydroergotamine in Migraine From 1906 and Onward

Ergotamine and DHE had widespread use as the only specific antimigraine drugs before the triptan era and recently, oral ergotamine, which has an oral bioavailability of < 1%, has been inferior to oral triptans in randomized clinical trials.

Dihydroergotamine nasal spray for the acute treatment of migraine

DHE nasal spray is a safe and effective treatment for the pain and nausea of migraine attacks and both the patients' and physicians' ratings indicated that DHE was significantly superior to placebo in improving headache and nausea.