From the Guidelines
Ergotamine withdrawal symptoms can include severe headaches, nausea, vomiting, anxiety, restlessness, sleep disturbances, and intense cravings for the medication, typically beginning within 24-48 hours after stopping ergotamine and lasting for several days to weeks 1.
Symptoms of Ergotamine Withdrawal
The symptoms of ergotamine withdrawal are similar to those of other medication overuse headaches, and can include:
- Severe headaches
- Nausea and vomiting
- Anxiety and restlessness
- Sleep disturbances
- Intense cravings for the medication These symptoms can vary in severity and duration, depending on the individual and the length of time they have been taking ergotamine.
Management of Ergotamine Withdrawal
It is essential to consult a healthcare provider if experiencing withdrawal symptoms, as they may recommend a gradual tapering schedule rather than abrupt discontinuation 1. The healthcare provider may also prescribe alternative medications to manage symptoms during withdrawal, such as pain relievers or anti-nausea medications. Additionally, staying hydrated, getting adequate rest, and using non-pharmacological pain management techniques, such as relaxation therapy or acupuncture, can help manage symptoms during this period.
Prevention of Ergotamine Withdrawal
To prevent ergotamine withdrawal, it is crucial to use the medication only as directed and to avoid frequent or excessive use 1. Preventive therapy, such as migraine prophylaxis, should be considered if the patient has more than two headaches per week. By managing ergotamine use and preventing withdrawal, individuals can reduce the risk of severe headaches and other symptoms associated with medication overuse headaches.
From the FDA Drug Label
In rare instances, patients, particularly those who have used the medication indiscriminately over long periods of time, may display withdrawal symptoms consisting of rebound headache upon discontinuation of the drug. The symptoms of ergotamine withdrawal are rebound headache. 2
From the Research
Symptoms of Ergotamine Withdrawal
The symptoms of ergotamine withdrawal can include:
- Headache, often severe and prolonged 3, 4, 5
- Nausea and vomiting 3, 4
- Sleep disturbances 3
- Coldness in the extremities 4
- Other symptoms of ergotamine toxicity, such as rebound headache 5, 6
Duration and Severity of Withdrawal Symptoms
The duration and severity of ergotamine withdrawal symptoms can vary depending on the individual and the dose and duration of ergotamine use. Studies have shown that:
- The duration of withdrawal headache was shorter in patients overusing triptans (4.1 days) than in patients overusing ergots (6.7 days) or analgesics (9.5 days) 3
- The mean headache intensity on the first day of withdrawal did not differ between the groups, but by day 14, it was lower in patients overusing triptans than in patients overusing ergots or analgesics 3
- The duration and severity of withdrawal symptoms did not correlate with the doses and plasma levels of ergotamine 4
Treatment and Outcome
Treatment of ergotamine withdrawal typically involves discontinuation of the drug, followed by structured acute therapy and initiation of specific prophylactic treatment for the underlying primary headache. Studies have shown that: