We read with great interest the article by Winner et al1 in the Archives. This is the first study on sumatriptan and dihydroergotamine, both administered subcutaneously. One previous study,2 published in abstract form, reported on subcutaneous sumatriptan and low-dose intranasal dihydroergotamine and did not allow any reliable conclusion regarding comparison of the 2 drugs. Moreover, since sumatriptan costs more than dihydroergotamine, others3 have recently raised the question of whether the advantages of sumatriptan could offset this price difference.
The results of the study by Winner et al confirm the clinical impression that subcutaneous sumatriptan and dihydroergotamine are equally effective in aborting migraine attacks, although sumatriptan showed a speedier effect than dihydroergotamine, which in turn got a longer-lasting effect (probably because of its longer half-life). Previous studies reported that subcutaneous sumatriptan produces significant relief of headache at 10 minutes after treatment compared with placebo, with 50% of patients
Catarci T, Cerbo R. Subcutaneous Dihydroergotamine vs Subcutaneous Sumatriptan. Arch Neurol. 1996;53(12):1215. doi:10.1001/archneur.1996.00550120017005
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