One of the medications your doctor may prescribe for migraine is Methergine (a brand name), otherwise known as methylergonovine maleate. Usually used for postpartum hemorrhage (bleeding), you may wonder how this medication is used for migraine, particularly migraine prevention.
Methylergonovine maleate is known as a ergot psychedelic alkaloid. You may be familiar with more common migraine medications with the word "ergot" in them (medications derived from the ergot fungi, as methylergonovine maleate often is), such as ergotamine (ie Cafergot) or dihydroergotamine (ie Migranal or DHE).
But these are generally used as abortives (when you have a migraine attack), whereas Methergine is usually used as a preventative. It’s also related to another preventative – methysergide (ie Sansert and Deseril). In fact, some doctors will use methylergonovine maleate in the place of methysergide, since it becomes methysergide in your body anyway.
Methergine influences blood flow because of the way it leads to blood vessel constriction. It also changes serotonin use in the body (inhibiting or blocking its effects), which are known to relate to migraine (actually, this is related to the constriction). But as with all migraine medications, there is some question about how exactly they work, and we’re relying on clinical studies to show us how well they do work.
Methylergonovine maleate is not usually tried for the length of time that most other migraine medication is given for (usually 3 months). Your doctor will probably want to check on you after only 3 weeks or so. Also, you will be taking breaks from the medication for 3-4 weeks after you’ve taken it for 6 months (to avoid the rare possibility of fibrosis). Your doctor will want to supervise you closely, and she will probably want you to go off it slowly.
Occasionally, methylergonovine maleate will be given for other things besides various types of migraine. Most notably, cluster headache. Also, it can be given as an abortive for migraine, particularly when you have a migraine that just won’t stop.
Of course you’ll be talking to your doctor before taking this drug (a doctor who knows your medical history), but here are a few things to keep in mind. This drug is generally not given during pregnancy. Also, your doctor needs to know if you have hypertension (high blood pressure) or liver or kidney problems. Be sure to tell your doctor if you experience side effects to this drug. Finally, don’t take it with juice (especially grapefruit juice).
Methergine will be a long way from the top of the list of things your doctor will prescribe. However, it’s also not at the bottom of the list. If your doctor says you’ve tried everything, she’s wrong. Please find another specialist who will keep working with you.