Dihydroergotamine, Ergotamine, Methysergide and Sumatriptan – Basic Science in Relation to Migraine Treatment

Authors

  • Carl Dahlöf MD, PhD,

    Corresponding author
    1. From the Gothenburg Migraine Clinic AB, Gothenburg, Sweden (C. Dahlöf); Erasmus University Medical Centre, Rotterdam, The Netherlands (A. Maassen Van Den Brink).
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  • Antoinette Maassen Van Den Brink PhD

    1. From the Gothenburg Migraine Clinic AB, Gothenburg, Sweden (C. Dahlöf); Erasmus University Medical Centre, Rotterdam, The Netherlands (A. Maassen Van Den Brink).
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  • Conflict of Interest: None.

C.G.H. Dahlöf, Gothenburg Migraine Clinic AB, Hovås Lingonstig 4, SE-436 55 Hovås, Sweden.

Abstract

The 5-hydroxytryptamine (5-HT) receptor family mediates the effects of several drugs highly effective in migraine primarily by activating 5-HT1B, 5-HT1D, and 5-HT1F receptors. Ergotamine, dihydroergotamine, and methysergide, as well as the “triptan” sumatriptan, are all agonists for these receptors. The receptor profile and degree of selectivity of these four drugs differ, which is reflected by their side effects that limit their use in the acute and prophylactic treatment of migraine. The acute antimigraine efficacy of these remedies is very much dependent on the formulation used where, in general, parenteral formulations are more effective in reliving the symptoms of a migraine attack.

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