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September 25, 1954


Author Affiliations

VA Mental Hygiene Clinic 1305 Franklin St., Oakland 12, Calif.

JAMA. 1954;156(4):448. doi:10.1001/jama.1954.02950040154026

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To the Editor:—  Ergotamine tartrate and caffeine can be absorbed from mucous membrane. Because many patients with migraine or tension headaches are too nauseated to tolerate these drugs by mouth, and because it is difficult to arrange for administration of ergotamine tartrate hypodermically at the onset of an attack, it has been advised that they be administered rectally. This was first suggested in 1894 by Thomson, who used tincture of ergot for "periodic neuralgia of the head." More recently the use of these drugs has been reported in the form of suppositories or tablets (Cafergot). I wish to call attention to a much more satisfactory procedure in these cases. The patient is instructed to break the tablets (Cafergot) between his teeth and allow them to be absorbed from the area between the teeth and cheek. The tablets have a moderately bitter taste, but patients with severe headaches seldom complain of

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