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S Evers - One of the best experts on this subject based on the ideXlab platform.
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carotid artery dissection in Ergotamine abuse
Headache, 2004Co-Authors: Esra Akovaozturk, I W Husstedt, Bernd E Ringelstein, S EversAbstract:The case of a 65-year-old male migraine patient with spontaneous internal carotid artery dissection is presented. He had been abusing Ergotamine compounds for several years on at least 15 days per month. A possible association between arterial dissection and Ergotamine abuse is discussed.
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sumatriptan and Ergotamine overuse and drug induced headache a clinicoepidemiologic study
Clinical Neuropharmacology, 1999Co-Authors: S Evers, B Bauer, I W Husstedt, I Gralow, B Suhr, A Buchheister, E B RingelsteinAbstract:: Drug-induced headache, particularly Ergotamine-induced headache, is a common problem in migraine treatment. Some case reports suggest that even the new serotonergic antimigraine drugs such as sumatriptan can lead to overuse and subsequent drug-induced headache. We performed a controlled study to identify the rate of sumatriptan overuse and sumatriptan-induced headache and compared it to the rate of Ergotamine overuse and Ergotamine-induced headache. Two thousand sixty-five consecutive heachache patients, all experienced in intake of sumatriptan (n = 631) or Ergotamine (n = 620), were enrolled over a three-year study period. The rates of overuse and drug-induced headache and the clinical features of the subgroups were compared. Risk factors for sumatriptan overuse were identified. The rates of Ergotamine and sumatriptan overuse were 14.2% and 3.5%, respectively (p < 0.001). Drug-induced headache could be found more frequently in cases of Ergotamine overuse than in cases of sumatriptan overuse (68% versus 32%; p < 0.01). Development of sumatriptan overuse was most common in patients with previous drug-induced headache (68%), combined headache as the primary headache type (45%), and subcutaneous application of sumatriptan (45%). We conclude that sumatriptan intake can lead to overuse and subsequent drug-induced headache. The risk for overuse and drug-induced headache is significantly lower than in patients with Ergotamine intake. This might be caused in part by the relatively short period of sumatriptan availability on the market. The new generation of serotonin-1B/D-receptor agonists in the treatment of headache should have a potential for overuse similar to that of traditional headache drugs.
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the impact of Ergotamine induced headache and Ergotamine withdrawal on information processing
Psychopharmacology, 1999Co-Authors: S Evers, Felix Schmidt, B Bauer, Heike Voss, K H Grotemeyer, I W HusstedtAbstract:Ergotamine abuse and subsequent Ergotamine-induced headache is a common problem in the pharmacological treatment of migraine and other headache types; often, withdrawal therapy is necessary. This study investigated whether Ergotamine abuse affects information processing and whether withdrawal therapy can lead to an improvement of information processing. We designed a standardized neurophysiological retrospective (Ergotamine abuse) and prospective (Ergotamine withdrawal) study in a supraregional headache outpatient clinic. Seventy-one patients abusing Ergotamine derivatives with subsequent daily headache were enrolled and compared to 36 migraine patients without Ergotamine intake and 36 healthy subjects. Information processing was evaluated by latencies and amplitudes of visually evoked event-related potentials (ERP) before and after Ergotamine withdrawal therapy. P3 latency of the ERP was significantly increased in Ergotamine abuse (442 ± 45 ms) versus migraine (415 ± 40 ms) and healthy subjects (410 ± 33 ms), there was no difference between Ergotamine tartrate and dihydroErgotamine abuse. The migraine specific loss of habituation in information processing as measured by P3 latency could not be observed in migraine patients with Ergotamine abuse. After successful withdrawal therapy in 36 patients, the abnormally prolonged P3 latency was significantly shortened (452 ± 47 ms versus 433 ± 30 ms; P < 0.004). Our findings imply that information processing is impaired by Ergotamine abuse and can be improved but not normalized after withdrawal therapy. Furthermore, our data provide strong evidence that Ergotamine, besides its peripheral effects, has a central mode of action.
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headache caused by a sphenoid mucocele but presenting as an Ergotamine induced headache
Headache, 1997Co-Authors: B Bauer, S Evers, Hans W Lindorfer, G Schuierer, H Henningsen, I W HusstedtAbstract:: In a 65-year-old woman, symptomatic headache caused by a mucocele of the sphenoid sinus led to Ergotamine abuse and subsequent Ergotamine-induced headache. Since there were no neurological symptoms initially and the patient previously suffered from migraine, the mucocele was not recognized. Only after unsuccessful drug withdrawal therapy and an MRI, was the correct diagnosis made. Surgical removal of the mucocele led to complete relief of headache within 3 weeks. We conclude that Ergotamine-induced headache can develop on the basis of symptomatic headache. In spite of the effectiveness of Ergotamine tartrate, an MRI should be performed if focal neurological symptoms occur.
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Headache Caused by a Sphenoid Mucocele but Presenting as an Ergotamine‐Induced Headache
Headache, 1997Co-Authors: B Bauer, S Evers, Hans W Lindorfer, G Schuierer, H Henningsen, Ingo W. HusstedtAbstract:In a 65-year-old woman, symptomatic headache caused by a mucocele of the sphenoid sinus led to Ergotamine abuse and subsequent Ergotamine-induced headache. Since there were no neurological symptoms initially and the patient previously suffered from migraine, the mucocele was not recognized. Only after unsuccessful drug withdrawal therapy and an MRI, was the correct diagnosis made. Surgical removal of the mucocele led to complete relief of headache within 3 weeks. We conclude that Ergotamine-induced headache can develop on the basis of symptomatic headache. In spite of the effectiveness of Ergotamine tartrate, an MRI should be performed if focal neurological symptoms occur.
Wulf-dieter Moll - One of the best experts on this subject based on the ideXlab platform.
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Rhodococcus erythropolis MTHt3 biotransforms ergopeptines to lysergic acid
BMC Microbiology, 2015Co-Authors: Michaela Thamhesl, Elisabeth Apfelthaler, Heidi Elisabeth Schwartz-zimmermann, Elisavet Kunz-vekiru, Gerd Schatzmayr, Rudolf Krska, Wolfgang Kneifel, Wulf-dieter MollAbstract:Background Ergopeptines are a predominant class of ergot alkaloids produced by tall fescue grass endophyte Neotyphodium coenophialum or cereal pathogen Claviceps purpurea . The vasoconstrictive activity of ergopeptines makes them toxic for mammals, and they can be a problem in animal husbandry. Results We isolated an ergopeptine degrading bacterial strain, MTHt3, and classified it, based on its 16S rDNA sequence, as a strain of Rhodococcus erythropolis ( Nocardiaceae, Actinobacteria ). For strain isolation, mixed microbial cultures were obtained from artificially ergot alkaloid-enriched soil, and provided with the ergopeptine Ergotamine in mineral medium for enrichment. Individual colonies derived from such mixed cultures were screened for Ergotamine degradation by high performance liquid chromatography and fluorescence detection. R. erythropolis MTHt3 converted Ergotamine to ergine (lysergic acid amide) and further to lysergic acid, which accumulated as an end product. No other tested R. erythropolis strain degraded Ergotamine. R. erythropolis MTHt3 degraded all ergopeptines found in an ergot extract, namely Ergotamine, ergovaline, ergocristine, ergocryptine, ergocornine, and ergosine, but the simpler lysergic acid derivatives agroclavine, chanoclavine, and ergometrine were not degraded. Temperature and pH dependence of Ergotamine and ergine bioconversion activity was different for the two reactions. Conclusions Degradation of ergopeptines to ergine is a previously unknown microbial reaction. The reaction end product, lysergic acid, has no or much lower vasoconstrictive activity than ergopeptines. If the genes encoding enzymes for ergopeptine catabolism can be cloned and expressed in recombinant hosts, application of ergopeptine and ergine degrading enzymes for reduction of toxicity of ergot alkaloid-contaminated animal feed may be feasible.
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Rhodococcus erythropolis MTHt3 biotransforms ergopeptines to lysergic acid
BMC Microbiology, 2015Co-Authors: Michaela Thamhesl, Elisabeth Apfelthaler, Heidi Elisabeth Schwartz-zimmermann, Elisavet Kunz-vekiru, Gerd Schatzmayr, Rudolf Krska, Wolfgang Kneifel, Wulf-dieter MollAbstract:Ergopeptines are a predominant class of ergot alkaloids produced by tall fescue grass endophyte Neotyphodium coenophialum or cereal pathogen Claviceps purpurea. The vasoconstrictive activity of ergopeptines makes them toxic for mammals, and they can be a problem in animal husbandry. We isolated an ergopeptine degrading bacterial strain, MTHt3, and classified it, based on its 16S rDNA sequence, as a strain of Rhodococcus erythropolis (Nocardiaceae, Actinobacteria). For strain isolation, mixed microbial cultures were obtained from artificially ergot alkaloid-enriched soil, and provided with the ergopeptine Ergotamine in mineral medium for enrichment. Individual colonies derived from such mixed cultures were screened for Ergotamine degradation by high performance liquid chromatography and fluorescence detection. R. erythropolis MTHt3 converted Ergotamine to ergine (lysergic acid amide) and further to lysergic acid, which accumulated as an end product. No other tested R. erythropolis strain degraded Ergotamine. R. erythropolis MTHt3 degraded all ergopeptines found in an ergot extract, namely Ergotamine, ergovaline, ergocristine, ergocryptine, ergocornine, and ergosine, but the simpler lysergic acid derivatives agroclavine, chanoclavine, and ergometrine were not degraded. Temperature and pH dependence of Ergotamine and ergine bioconversion activity was different for the two reactions. Degradation of ergopeptines to ergine is a previously unknown microbial reaction. The reaction end product, lysergic acid, has no or much lower vasoconstrictive activity than ergopeptines. If the genes encoding enzymes for ergopeptine catabolism can be cloned and expressed in recombinant hosts, application of ergopeptine and ergine degrading enzymes for reduction of toxicity of ergot alkaloid-contaminated animal feed may be feasible.
Peer Tfelthansen - One of the best experts on this subject based on the ideXlab platform.
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arterial response to Ergotamine tartrate in abusing and non abusing migraine patients
Pharmacology & Toxicology, 2009Co-Authors: Peer Tfelthansen, Jes OlesenAbstract:: Ten former Ergotamine abusers were given Ergotamine tartrate 0.5 mg/70 kg intravenously. The arterial response was followed by measuring systolic blood pressures with strain gauge on arm, fingers, ankles and toes. Distal systolic blood pressures were significantly reduced relative to the arm level for 22 hours. The arterial response in these 10 patients was compared to the response in 17 migraine patients tested with the same technique. No differences were found. We conclude that hypersensitivity or tolerance to Ergotamine tartrate is not observed in previous Ergotamine abusers. Previous abuse is a relative contraindication to the use of Ergotamine. But if Ergotamine is the only effective drug, normal dosage can be used according to the present results.
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mechanism of Ergotamine induced decrease of peripheral systolic blood pressure in man
Pharmacology & Toxicology, 2009Co-Authors: Peer Tfelthansen, Jens H Eickhoff, Jes OlesenAbstract:: We have previously reported a consistent decrease of peripheral-central systolic blood pressure (SBP) gradients after Ergotamine. SBP was measured with cuffs and it is unknown whether measured values reflect changes of intra-arterial SBP or increase of vessel wall tone beneath the cuffs. We hence studied the effect of Ergotamine tartrate 0.5 mg intravenously on finger-arm systolic gradients after the following procedures: Infiltration around finger arteries with papaverine (n = 2) and dihydralazine (n = 3), occlusion of blood supply to a finger by an inflated cuff before and 2 hours after Ergotamine (n = 6). A normal reduction in finger-arm systolic gradients was seen. The Ergotamine-induced decrease of peripheral SBP must therefore be due to a fall in peripheral intra-arterial SBP i.e. to contraction of arteries proximal to the digital arteries. Intra-arterial injection of 10 micrograms Ergotamine tartrate caused similar decrease in finger-arm systolic gradients as intravenous administration of 0.5 mg (n = 1) indicating a peripheral site of action.
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the effect of single dose Ergotamine tartrate on peripheral arteries in migraine patients methodological aspects and time effect curve
Pharmacology & Toxicology, 2009Co-Authors: Peer Tfelthansen, Jens H Eickhoff, Jes OlesenAbstract:: Ergotamine tartrate (0.5 mg/70 kg) was given intravenously to 17 migraine patients. Arm, finger, ankle and big toe systolic blood pressures were measured with strain gauge technique for up to 4 hours and again after 22 hours. Systolic arm blood pressure increased transiently (duration less than 3 hours). Peripheral systolic blood pressures decreased in all patients (for toes a few to 55 mmHg) and at 22 hours well sustained decreases were still found. Further 10 migraine patients received 2-4 mg Ergotamine tartrate as suppositories and peripheral systolic blood pressures were measured for 3 days. A decrease in peripheral systolic blood pressure was found after 24 hours but had disappeared after 48 hours. Contrary to common belief the present study investigating the effect of Ergotamine directly on arteries has shown a long duration of its vasoconstrictory effect. Thus the effect of a single dose of Ergotamine on the arteries should be followed for days.
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history of the use of Ergotamine and dihydroErgotamine in migraine from 1906 and onward
Cephalalgia, 2008Co-Authors: Peer Tfelthansen, Peter J KoehlerAbstract:Dale showed in 1906 in a seminal work that ergot inhibits the pressor effect of adrenaline. Stoll at Sandoz isolated Ergotamine from ergot in 1918. Based on the belief that migraine was due to increased sympathetic activity, Ergotamine was first used in the acute treatment of migraine by Maier in Switzerland in 1925. In 1938 Graham and Wolff demonstrated the parallel decrease of temporal pulsations and headache after Ergotamine i.v. This inspired the vascular theory of Wolff: an initial cerebral vasoconstriction followed by an extracranial vasodilation. DihydroErgotamine (DHE) was introduced as an adrenolytic agent in 1943. It is still in use parenterally and by the nasal route. Before the triptan era Ergotamine and DHE had widespread use as the only specific antimigraine drugs. From 1950 the world literature on Ergotamine was dominated by two adverse events: Ergotamine overuse headache and the relatively rare overt ergotism. Recently, oral Ergotamine, which has an oral bioavailability of < 1%, has been i...
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the effect of rizatriptan Ergotamine and their combination on human peripheral arteries a double blind placebo controlled crossover study in normal subjects
British Journal of Clinical Pharmacology, 2002Co-Authors: Peer Tfelthansen, Kaj Seidelin, M Stepanavage, Christopher R LinesAbstract:Aims To compare the peripheral vasoconstrictor effects of Ergotamine, rizatriptan, and their combination, in normal subjects. Methods This was a double-blind, four-way, crossover study. Sixteen young male volunteers, selected as responders to the vasoconstrictor effect of 0.5 mg Ergotamine i.v., were administered 10 mg oral rizatriptan, 0.25 mg i.v. Ergotamine, 10 mg oral rizatriptan+0.25 mg i.v. Ergotamine, and placebo. The vasoconstrictor effect on peripheral arteries was measured with strain gauge plethysmography up to 8 h after dosing. The 8 h assessment period was divided into two 4 h intervals to assess the immediate (0–4 h) vs sustained effect (4–8 h) of treatment. Results For the 0–4 h interval, the decreases in peripheral systolic blood pressure gradients were: placebo (−1 mmHg [95% CI: −3, 1])
Carl Dahlof - One of the best experts on this subject based on the ideXlab platform.
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Ergotamine in the acute treatment of migraine a review and european consensus
Brain, 2000Co-Authors: Peer Tfelthansen, Miguel J A Lainez, Carl Dahlof, P R Saxena, Julio Pascual, Patrick Henry, H C Diener, Jean Schoenen, Michel D Ferrari, Peter J GoadsbyAbstract:Ergotamine has been used in clinical practice for the acute treatment of migraine for over 50 years, but there has been little agreement on its place in clinical practice. An expert group from Europe reviewed the pre-clinical and clinical data on Ergotamine as it relates to the treatment of migraine. From this review, specific suggestions for the patient groups and appropriate use of Ergotamine have been agreed. In essence, Ergotamine, from a medical perspective, is the drug of choice in a limited number of migraine sufferers who have infrequent or long duration headaches and are likely to comply with dosing restrictions. For most migraine sufferers requiring a specific antimigraine treatment, a triptan is generally a better option from both an efficacy and side-effect perspective.
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placebo controlled clinical trials with Ergotamine in the acute treatment of migraine
Cephalalgia, 1993Co-Authors: Carl DahlofAbstract:Although oral Ergotamine alone or in combination with caffeine is widely used for the acute treatment of migraine, there is little evidence that it is significantly more effective than placebo. There are no placebo-controlled data to support the use of aerosol or suppository formulations. In addition, the recommended doses of Ergotamine cannot be justified. Each formulation of Ergotamine now should be tested in clinical studies performed according to the IHS criteria for trial design and in migraine patients fulfilling the diagnostic criteria of the IHS. Until these clinical data are available, no dear recommendations can be given for the use of Ergotamine in the acute treatment of migraine.
I W Husstedt - One of the best experts on this subject based on the ideXlab platform.
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carotid artery dissection in Ergotamine abuse
Headache, 2004Co-Authors: Esra Akovaozturk, I W Husstedt, Bernd E Ringelstein, S EversAbstract:The case of a 65-year-old male migraine patient with spontaneous internal carotid artery dissection is presented. He had been abusing Ergotamine compounds for several years on at least 15 days per month. A possible association between arterial dissection and Ergotamine abuse is discussed.
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sumatriptan and Ergotamine overuse and drug induced headache a clinicoepidemiologic study
Clinical Neuropharmacology, 1999Co-Authors: S Evers, B Bauer, I W Husstedt, I Gralow, B Suhr, A Buchheister, E B RingelsteinAbstract:: Drug-induced headache, particularly Ergotamine-induced headache, is a common problem in migraine treatment. Some case reports suggest that even the new serotonergic antimigraine drugs such as sumatriptan can lead to overuse and subsequent drug-induced headache. We performed a controlled study to identify the rate of sumatriptan overuse and sumatriptan-induced headache and compared it to the rate of Ergotamine overuse and Ergotamine-induced headache. Two thousand sixty-five consecutive heachache patients, all experienced in intake of sumatriptan (n = 631) or Ergotamine (n = 620), were enrolled over a three-year study period. The rates of overuse and drug-induced headache and the clinical features of the subgroups were compared. Risk factors for sumatriptan overuse were identified. The rates of Ergotamine and sumatriptan overuse were 14.2% and 3.5%, respectively (p < 0.001). Drug-induced headache could be found more frequently in cases of Ergotamine overuse than in cases of sumatriptan overuse (68% versus 32%; p < 0.01). Development of sumatriptan overuse was most common in patients with previous drug-induced headache (68%), combined headache as the primary headache type (45%), and subcutaneous application of sumatriptan (45%). We conclude that sumatriptan intake can lead to overuse and subsequent drug-induced headache. The risk for overuse and drug-induced headache is significantly lower than in patients with Ergotamine intake. This might be caused in part by the relatively short period of sumatriptan availability on the market. The new generation of serotonin-1B/D-receptor agonists in the treatment of headache should have a potential for overuse similar to that of traditional headache drugs.
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the impact of Ergotamine induced headache and Ergotamine withdrawal on information processing
Psychopharmacology, 1999Co-Authors: S Evers, Felix Schmidt, B Bauer, Heike Voss, K H Grotemeyer, I W HusstedtAbstract:Ergotamine abuse and subsequent Ergotamine-induced headache is a common problem in the pharmacological treatment of migraine and other headache types; often, withdrawal therapy is necessary. This study investigated whether Ergotamine abuse affects information processing and whether withdrawal therapy can lead to an improvement of information processing. We designed a standardized neurophysiological retrospective (Ergotamine abuse) and prospective (Ergotamine withdrawal) study in a supraregional headache outpatient clinic. Seventy-one patients abusing Ergotamine derivatives with subsequent daily headache were enrolled and compared to 36 migraine patients without Ergotamine intake and 36 healthy subjects. Information processing was evaluated by latencies and amplitudes of visually evoked event-related potentials (ERP) before and after Ergotamine withdrawal therapy. P3 latency of the ERP was significantly increased in Ergotamine abuse (442 ± 45 ms) versus migraine (415 ± 40 ms) and healthy subjects (410 ± 33 ms), there was no difference between Ergotamine tartrate and dihydroErgotamine abuse. The migraine specific loss of habituation in information processing as measured by P3 latency could not be observed in migraine patients with Ergotamine abuse. After successful withdrawal therapy in 36 patients, the abnormally prolonged P3 latency was significantly shortened (452 ± 47 ms versus 433 ± 30 ms; P < 0.004). Our findings imply that information processing is impaired by Ergotamine abuse and can be improved but not normalized after withdrawal therapy. Furthermore, our data provide strong evidence that Ergotamine, besides its peripheral effects, has a central mode of action.
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headache caused by a sphenoid mucocele but presenting as an Ergotamine induced headache
Headache, 1997Co-Authors: B Bauer, S Evers, Hans W Lindorfer, G Schuierer, H Henningsen, I W HusstedtAbstract:: In a 65-year-old woman, symptomatic headache caused by a mucocele of the sphenoid sinus led to Ergotamine abuse and subsequent Ergotamine-induced headache. Since there were no neurological symptoms initially and the patient previously suffered from migraine, the mucocele was not recognized. Only after unsuccessful drug withdrawal therapy and an MRI, was the correct diagnosis made. Surgical removal of the mucocele led to complete relief of headache within 3 weeks. We conclude that Ergotamine-induced headache can develop on the basis of symptomatic headache. In spite of the effectiveness of Ergotamine tartrate, an MRI should be performed if focal neurological symptoms occur.
