Clinical Experience With Patient Administered Subcutaneous Dihydroergotamine Mesylate in Refractory Headaches

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Abstract
SYNOPSISThis study examines the practicality and efficacy of dihydroergotamine mesylate (DHE) when self‐administered sub‐cutaneously in a population of refectory headache patients. Forty‐three patients with chronic daily headache or migraine headache without aura, who had been taught self‐injection of DHE either through the Raskin Protocol or in an outpatient headache clinic, were contacted by telephone and administered a questionnaire regarding usage and results from DHE injection. Ninety‐two percent of patients could successfully administer DHE. Forty‐six percent of patients experienced 90% or greater relief of pain and the majority of patients (77%) had greater than 50% relief. Emergency room use was decreased in 83% and 80% preferred DHE to their previous therapy. While side effects were common (79%), only four patients (9%) stopped DHE for this reason. No convincing evidence for the development of rebound headaches due to DHE was found in this sample.

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