The way to serotonergic use and abuse in migraine.
5-HT is currently indicated to play a role in migraine (M). Previously evidenced 5-HT supersensitivity which characterizes M is insufficient to compensate for a possible deficit in 5-HT bioavailability. Inducing a further up-regulation of 5-HT receptor can yield improvement of M syndrome. Chronic treatments of methysergide and propranolol, drugs exerting antagonist action at 5-HT receptors, induced a significant amelioration in 256M sufferers. On the contrary, chronic treatments of ergotamine and sumatriptan, both provided with a 5-HT1 agonist activity, induced a worsening of M in 134 M sufferers. The M worsening was paralleled by an increase in consumption of analgesic drugs. Discussion concerns the effects of the chronically given 5-HT agonists and antagonists as well as the possible receptor mechanism underlying "craving for serotonin" in severe M. The increase of 5-HT supersensitivity evidenced at the end of M attacks is also discussed and its role in determining the interruption of the attack is here suggested.
Nicolodi
M
M
Interuniversity Centre of Neurochemistry and Clinical Pharmacology of Idiopathic Headache, Florence University, Italy.
Del Bianco
P L
PL
Sicuteri
F
F
D000328:Adult; D001519:Behavior / Q000187:drug effects; D004311:Double-Blind Method; D004878:Ergotamine / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008784:Methysergide / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000378:metabolism; D011433:Propranolol / Q000494:pharmacology / Q000627:therapeutic use; D012702:Serotonin Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D017366:Serotonin Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D018170:Sumatriptan / Q000494:pharmacology / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000494:pharmacology / Q000627:therapeutic use
D012702:Serotonin Antagonists; D017366:Serotonin Receptor Agonists; D014662:Vasoconstrictor Agents; D018170:Sumatriptan; D011433:Propranolol; D004878:Ergotamine; D008784:Methysergide