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August 5, 1974

Methysergide Alopecia

JAMA. 1974;229(6):639. doi:10.1001/jama.1974.03230440015011

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To the Editor.—  May I call the attention of your readers to an uncommon side effect of methysergide, which is used in the prophylaxis of migraine and related headaches? A woman, aged 30, subject to frequent migraine attacks, was given methysergide, 2 mg twice daily. After two months she began losing scalp hair, although the migraine attacks remained in abeyance. Methysergide dosage was reduced to 2 mg daily. On this regimen, she had a few headaches, but hair loss continued, requiring a wig. After one month, methysergide therapy was discontinued and hair loss was reversed. This is a highly uncommon side effect of methysergide and has been reported only rarely. The hair loss may be self-limiting, despite the use of the drug. Spontaneous hair loss in patients with migraine or other disorders is also reported, but in this case seems unlikely.