ERGOTAMINE CAFFEINE TREATMENT OF ORTHOSTATIC HYPOTENSION IN PARKINSONISM WITH AUTONOMIC FAILURE/

Eight patients with parkinsonism who developed severe orthostatic hypo tension, were treated with oral ergotamine/caffeine. Significant long- term improvement in standing systolic blood pressure and symptoms of s yncope and lightheadedness were observed in four of these patients. On e patient in whom the drug was effective discontinued it because of na usea. Another lost benefit after 2 weeks of successful therapy. Signif icant supine systolic hypertension occurred in only one patient, which was easily managed by nifedipine given at night. Symptoms or signs of ergotism were not observed. Oral ergotamine/caffeine should be consid ered as a cost-effective treatment for refractory orthostatic hypotens ion in carefully selected patients with parkinsonism. Eur J Neurol 5:5 93-599 (C) 1998 Lippincott Williams & Wilkins.