EFFECTIVENESS OF SUBCUTANEOUS DIHYDROERGOTAMINE BY HOME INJECTION FORMIGRAINE

The effectiveness of dihydroergotamine administered by home subcutaneo us injection by the patient or family for severe headache attacks was assessed retrospectively in 51 patients. Average follow-up was 21 week s. Twenty-one patients had intermittent migraine attacks, 27 had trans formed migraine with chronic daily headache, and 3 had chronic tension -type headache. Of the 51 patients taught home injection, 35% had an e xcellent overall response, 18% had a good response, 12% had a poor res ponse but continued to use dihydroergotamine, and 35% had discontinued dihydroergotamine use. Side effects were the main reason for stopping dihydroergotamine. These included nausea or vomiting or both, limb pa in or numbness or both, chest or throat tightness or both, and sorenes s at the injection site. Thirty-three patients (65%) continued to use dihydroergotamine at the end of the follow-up period. In patients who previously required injections from medical personnel for headache cri ses and in whom home injection of dihydroergotamine was effective, a d ramatic reduction occurred in hospital emergency room and physician of fice utilization. Dihydroergotamine use by home injection can be an ef fective treatment for a significant proportion of patients with severe migraine including patients with transformed migraine and medication overuse.