Headache methysergide

Herrman, W. M., Horowski, R., Dannehl, K., Kramer, U., and Lurati, K. (1977) Clinical effectiveness of lisuride hydrogen maleate A double-blind trial versus methysergide. Headache, 17 54-60. 

Hale, A. R., and Reed, A. F. (1962) Prophylaxis of frequent vascular headache with methysergide. 

Cluster headaches may be treated with a 5HTj-receptor agonist, e.g. sumatriptan, as for migraine. Since bouts of headache tend to be of limited duration, e.g. a few weeks, short courses of methysergide are justified in intractable cases. 

Methysergide Vasoconstrictor for headaches Claviceps purpurea Ergot... 

Bucci JA, Manoharan A. The management and monitoring of methysergide-indnced fibrosis. Headache Q 1998 9 321-5. 

Graham JR. Methysergide for prevention of headache experience in five hnndred patients over three years. N Engl J Med 1964 270 67-72. 

A myocardial infarction occurred in a 43-year-old woman with no known coronary artery disease who was taking methysergide and injected herself with sumatriptan 6 mg because of persisting headache (31). 

In patients unresponsive to other therapies, methysergide 4 to 8 mg/ day in divided doses is usually effective in shortening the course of cluster headaches. Response to treatment usually occurs within 1 week of initiation of the drug. Response rates in patients with episodic cluster headache approach 70%, but chronic cluster headache patients receive less benefit. Precautions regarding methysergide use were described earlier in this chapter. 

Corticosteroids are useful for chronic cluster headaches refractory to verapamil, lithium, ergotamine, and methysergide or combinations of these agents." Therapy is initiated with 40 to 60 mg/day prednisone and tapered over approximately 3 weeks. Relief appears within 1 to 2 days of initiating therapy. To avoid steroid-induced complications, long-term use is not recommended. Headaches may recur when therapy is tapered or discontinued. 

Graham, J.R. Cardiac and Pulmonary Fibrosis During Methysergide Therapy for Headache American J. of Med. Sci. (1967) 254 1-12... 

Graham, J.R. Suby, H.I. Le Compte, P.R. Sadowsky, N.L. Fibrotic Disorders Associated with Methysergide Therapy for Headache New England Journal of Medicine (1966) 274 359-368... 

Methysergide, a 5-HT c antagonist, has been used for the prophylactic treatment of migraine and other vascular headache, including Horton s syndrome. Calcium-entry blockers such as flunarizine have been shown to be effective in treating migraine. 

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