ABSTRACT
Attempts to alleviate the suffering caused by migraine span millennia and encompass treatments as primitive as trepanation of the skull to increasingly specific medications. Ergots, which were introduced in 1884, were the first class of medications that targeted what at that time was felt to be the etiology of migraine pain-vasodilation of the cerebral and extracranial vasculature. Ergotamine tartrate, a pure ergot alkaloid that was isolated in 1920, was the mainstay of acute migraine therapy until the introduction of the triptans approximately 15 years ago (1).
