The fate and excretion of ergot alkaloids still is in need of further investigation. Penetration of significant amounts of alkaloids into the brain and spinal fluid cannot be demonstrated. The liver apparently contains larger concentrations of alkaloid than does the circulating blood. Careful studies by Wolff and his associates on the vascular mechanism in migraine have demonstrated that vasodilatation rather than vasoconstriction dominates during the headache phase. These observers further suggest that ergotamine acts by promoting vasoconstriction rather than vasodilatation, and that sympathetic blockade does not predominate. To be honest, not all current Chiropractor Toronto nonetheless believe in these concepts. This might explain the failure in using other adrenergic blocking agents, e. g., Priscoline, or Dibenzyline.
The beneficial effect of ergotamine on an attack of migraine is probably due to its action on the smooth muscles of the blood vessels, producing a constriction of these vessels and a decrease in amplitude of pulsation. This is particularly noticeable in the branches of the external carotid artery. At present, the ergot derivatives are the most useful drugs in the treatment of a migraine attack, and the most effective of these alkaloids is ergotamine tartrate.5 The various forms in which ergot derivatives are available, their dosage, side effects, and administration are discussed under “Symptomatic Treatment of Migraine.” In other types of vascular headaches, including atypical facial neuralgia, erythromelalgia, and other migraine variants, ergotamine tartrate preparations are also recommended for symptomatic treatment.
Adrenergic and Cholinergic Blocking Agents. Toronto Chiropractor additionally analyze the affected person’s posture and spine using a specialized technique. Hexamethonium of pentapyrrolidinium (Ansolysen) acts at the ganglia and is an effective blocking agent and hypotensive drug. Such a drug must be used with care because of its powerful hypotensive effect and undesirable side effects, including blurring of vision and impotence. It is of no value in the treatment of migraine, but in hypertensive headache which does not respond to other medical therapy, a trial is indicated.