Parenteral dihydroergotamine for acute migraine
Clinical bottom line
Parenteral dihydroergotamine is less effective than subcutaneous sumatriptan, based on limited data.
Systematic review
A number of electronic databases were used to find studies of dihydroergotamine in migraine; searching was extensive. For inclusion studies had to be randomised trials of parenteral dihydroergotamine given for acute migraine attacks in emergency departments or headache clinic.
Reference
I Colman et al. Parenteral dihydroergotamine for acute migraine headache: a systematic review of the literature. Annals of Emergency Medicine 2005 45: 393-401.
- Date review completed: June 2003
- Number of trials included: 11
- Number of patients: 807
- Control group: Various active comparators. Dihydroergotamine usually given IV together with metoclopramide.
- Main outcomes: Pain, functional status, medication, relapse
Results
Two trials, one small, found that IV dihydroergotamine was less effective than subcutaneous sumatriptan for pain and nausea, but without giving figures. For most other comparisons, there were too many different comparators and interventions in small studies.
Comment
Parenteral dihydroergotamine is less effective than subcutaneous sumatriptan, based on limited data.