Cafergot for acute migraine

Clinical bottom line:

Cafergot (ergotamine tartrate 2 mg plus caffeine 200 mg) has been fully tested in one randomised trial with about 250 patients. It is probably unreliable to extrapolate too much from a single trial.

This information comes from an as-yet unpublished systematic review. The only outcome reported here is that of headache response at two hours, though other outcomes may be available in the full paper.

• Date review completed: September 2000
• Number of trials included: One randomised controlled trial
• Control group: Active and placebo
• Main outcomes: Headache intensity and duration

Inclusion criteria were: treatment of acute migraine; randomised allocation to treatment groups; double-blind design; adult population and headache outcomes.

Search

Comprehensive searches of the following databases were made: MEDLINE (1966 - July 2000), EMBASE (1980 - June 2000), Cochrane Library (Issue 3, 2000) and the Oxford Pain Relief Database (1950 - 1994). A series of free text searches were undertaken, using generic and trade names. There was no restriction to language. Retrieved reports were searched for additional trials. Neither individual authors nor pharmaceutical companies were contacted for unpublished data.

Findings

Tables with all included trials and excluded trials are available.

For oral cafergot (ergotamine tartrate 2 mg plus caffeine 200 mg), 58/169 patients (34%) had a headache response at two hours compared with 19/85 (22%) with placebo.

Adverse effects

Adverse effects are not reported in any way that makes obvious sense.