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ARTICLE |

ERGOTAMINE TOLERANCE IN PATIENTS WITH MIGRAINE

Arnold P. Friedman, M.D.; Percy Brazil, M.D.; Theodore J. C. von Storch, M.D.
JAMA. 1955;157(11):881-884. doi:10.1001/jama.1955.02950280005002.
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The use of ergot for the treatment of headache was first recommended in 1898 by Thomson1 in a medical textbook. In 1922 alkaloid ergotamine tartrate was developed, and several years after this its use in the treatment of migraine was suggested.2 Since then it has become generally recognized as the treatment of choice in migraine. In view of its widespread and sometimes indiscriminate use, particularly in the treatment of headaches, it seems appropriate to review the value and use of this medicament. In particular we would like to discuss the phenomenon of tolerance in relation to drugs of the ergot family.

PHARMACOLOGY AND PHYSIOLOGICAL EFFECTS OF ERGOT  Ergot, a fungus (dried sclerotium of Claviceps purpurea) growing on the grain of cereals, is obtained commercially from infected rye. All ergot alkaloids are derived from lysergic acid and are related chemically and with respect to their actions. They occur in

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