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September 19, 1980

Prazosin Treatment of Ergotamine-Induced Peripheral Ischemia

JAMA. 1980;244(12):1360. doi:10.1001/jama.1980.03310120048025

SEVERAL recent reports in the literature have recommended intravenous or intra-arterial sodium nitroprusside administration for the treatment of severe ergotamine-induced peripheral ischemia.1-4 Most treatments, prior to sodium nitroprusside, have been unsuccessful. Because of the similarities of action of prazosin and sodium nitroprusside,5,6 a trial of prazosin hydrochloride in the treatment of ergotism seemed reasonable. Peripheral ischemia of all four extremities and claudication of the right arm and leg were successfully treated with prazosin given orally.

Report of a Case  A 42-year-old woman was referred because of absent pulses and unobtainable blood pressure. She had a seven-year history of migraine headaches for which she had been taking suppositories containing 2 mg of ergotamine tartrate and 100 mg of caffeine (Cafergot) once weekly. During the 12 months before admission, the patient had used two suppositories daily (total dose of ergotamine, 28 mg weekly). In 1976 the patient had been examined