Ergot

Ergot is a fungus that grows on rye and less frequently on other grasses and cereals such as barley.

Ergot has an interesting history. During the Middle Ages, ergotism, a serious reaction to ergot-contaminated foods (such as rye bread), was widespread and known as St. Anthony's fire. This disease was often cured by visiting the shrine of St. Anthony, which was located in an ergot-free region of France. Some scientists also believe that ergot played a role in the Salem witch hunt of 1692. They believe that some women in Salem developed strange behavior as a result of eating ergot-contaminated food. This behavior led to them being condemned as witches and burned at the stake. Despite serious safety concerns, ergot is used as a medicine. Women use it to treat excessive bleeding during the menstrual period, at the beginning of the menopause and after miscarriages. They also use ergot after childbirth to promote the expulsion of the placenta and induce contraction of the uterus. Historically, ergot was used to hasten the onset of labor, but this use was discontinued after a link was established between ergot use and an increased number of stillbirths. Certain chemicals contained in ergot are used in prescription medications.

How does ergot work?

Ergot contains chemicals that can help reduce bleeding by constricting blood vessels.

How effective is ergot?

There is not enough scientific data to make a statement about the effectiveness of ergot in reducing bleeding during menstruation, promoting placental expulsion, when used during the menopause and in connection with miscarriage. Further scientific research is needed to evaluate the effectiveness of ergot in these applications.

Safety and side effects

Ergot is not safe and harmless. There is a high risk of poisoning, which can be fatal. Early symptoms of poisoning include nausea, vomiting, muscle pain and weakness, numbness, itching and a fast or slow heartbeat. Ergot poisoning can lead to gangrene, vision problems, confusion, spasms, convulsions, unconsciousness and death.

Precautions and warnings

The use of ergot is not safe for anyone, but some people have specific reasons not to use ergot:

Pregnancy and breastfeeding: ergot is not safe or safe for pregnant or breastfeeding women to use. Ergot has many effects that can be harmful during pregnancy and breastfeeding.

Heart disease: Ergot can constrict blood vessels and aggravate heart disease.

Kidney diseases: People who suffer from kidney problems are not able to excrete ergot well enough. This can cause ergot to accumulate in the body, increasing the risk of ergot poisoning.

Liver disorders: People who suffer from liver problems are not able to excrete ergot well enough. This can lead to ergot accumulating in the body, increasing the risk of ergot poisoning. Narrowing of the blood vessels that supply blood to the legs and feet (peripheral vascular disease): Ergot can constrict blood vessels and make this condition worse.

Interactions

Ergot should not be used in combination with the following medications:

Antidepressants

Ergot can increase the levels of the brain chemical serotonin. Some antidepressants also increase serotonin levels in the brain. Taking ergot in combination with these antidepressants could increase serotonin levels too much and cause serious side effects such as heart problems, tremors and anxiety. For this reason, ergot should not be used when taking antidepressants.

Medication for depression (monoamine oxidase inhibitors, MAOI)

Ergot can increase the levels of the brain chemical serotonin. Monoamine oxidase inhibitors also increase serotonin levels in the brain. Taking ergot in combination with these drugs could increase serotonin levels too much and cause serious side effects such as heart problems, tremors and anxiety

Care should be taken when combining horse chestnut with the following medications:

Dextromethorphan

Ergot can increase levels of the brain chemical serotonin. Dextromethorphan can also affect serotonin levels in the brain. Taking ergot in combination with dextromethorphan could increase serotonin levels too much and cause serious side effects such as heart problems, tremors and anxiety

Ergot derivatives

Ergot contains the same chemicals as ergot derivatives in prescription drugs. Taking ergot supplements in combination with prescription ergot derivatives may increase the effects and side effects of ergot.

Drugs that can reduce the breakdown of other drugs by the liver (cytochrome P450 3A4 (CYP3A4) inhibitors)

Some drugs are broken down by the liver. Some drugs can reduce the rate at which the liver breaks down ergot. Taking ergot in combination with some medicines that can slow down the breakdown of other medicines by the liver may increase the effects and side effects of ergot. You should talk to your doctor before taking ergot if you are taking medicines that may affect the breakdown of other medicines by the liver.

Meperidine

Ergot can increase levels of the brain chemical serotonin. Meperidine can also increase serotonin levels in the brain. Taking ergot in combination with meperidine could increase serotonin levels too much and cause serious side effects such as heart problems, tremors and anxiety

Pentazocine

Ergot can increase levels of the brain chemical serotonin. Pentazocine also increases serotonin levels in the brain. Taking ergot in combination with pentazocine could increase serotonin levels too much and cause serious side effects such as heart problems, tremors and anxiety. For this reason, ergot should not be used when taking pentazocine.

Stimulants

Stimulants accelerate the function of the nervous system. Accelerating the function of the nervous system can cause a feeling of inner restlessness and speed up the heartbeat. Ergot can also accelerate the function of the nervous system. Taking ergot in combination with stimulants can cause serious problems including increased heart rate and high blood pressure. For this reason, ergot should be avoided in combination with stimulants.

Tramadol

Tramadol can affect the brain chemical serotonin. Ergot can also affect serotonin levels. Taking ergot in combination with tramadol can increase serotonin levels in the brain too much and cause side effects including confusion, tremors, muscle stiffness and more.

Dosage

An appropriate dosage of ergot depends on various factors such as age, health status and others. At this time, there is insufficient scientific data to determine appropriate dosage ranges for ergot. For this reason, you should follow the dosage instructions on the label and/or consult a doctor or pharmacist before use.

References

Eadie MJ. Convulsive ergotism: epidemics of the serotonin syndrome? Lancet Neurol 2003;2:429-34.
Etzel RA. Mycotoxins. JAMA 2002;287:425-7.
Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3