To the Editor.
—Intravenously administered dihydroergotamine has been the preferred treatment for protracted, severe migraine attacks (status migrainous) for a number of years.1 The usual limiting factor in the use of dihydroergotamine is nausea and vomiting. Standard antiemetics, such as phomethazine hydrochloride (Phenergan), hydroxyzine and metoclopramide are usually ineffective. Persistent vomiting adds to the distress, may lead to dehydration, and patients usually decline repeated attempts at treatment with dihydroergotamine.A combination of haloperidol with lorazepam2 is used routinely at the Wisconsin Clinical Cancer Center, Madison, for the management of nausea associated with various types of chemotherapy.We have found that the intravenous administration of 0.5 to 1.0 mg each of haloperidol and lorazepam 15 minutes prior to the intravenous administration of dihydroergotamine prevents nausea and vomiting.
Report of Cases.
—A 37-year-old woman with a long history of classic migraine headaches and a 1-year history of severe depression was
Backonja M, Beinlich B, Dulli D, Schutta HS. Haloperidol and Lorazepam for the Treatment of Nausea and Vomiting Associated With the Treatment of Intractable Migraine Headaches. Arch Neurol. 1989;46(7):724. doi:10.1001/archneur.1989.00520430018012