Alpha-dihydroergocryptine and predictive factors in migraine prophylaxis.
OBJECTIVE
A double-blind, crossover study was carried out to compare the efficacy of alpha-dihydroergocryptine mesylate (10 mg twice daily) vs propranolol (40 mg twice daily) in the prophylaxis of migraine without aura, and to identify possible predictors of therapeutic response by evaluating the symptomatological profile of individual migraine attacks and the autonomic cardiovascular response to noradrenergic and dopaminergic (cold pressor, bromocriptine) tests.


METHODS
Forty migraineurs (10 males, 30 females) were randomized according to a two-period (3-month), two-treatment, crossover design. Efficacy was assessed using quantitative data recorded in the patient's headache diary. Data were evaluated using the Wallenstein's method.


RESULTS
Both drugs showed a significant reduction in all the efficacy variables (headache attacks, days with headache, analgesic consumption) with no difference between treatments. Neither a bromocriptine test, nor a cold pressor test nor the symptomatological profile of individual migraine attacks differed between the two groups of migraine patients. Ten patients experienced at least one adverse drug reaction during the first period of the crossover design, 5 being treated with alpha-dihydroergocryptine and 5 with propranolol.


CONCLUSIONS
It is concluded that alpha-dihydroergocryptine is an effective medication for migraine prophylaxis. The biochemical tests and the type of psychological profile cannot be used to predict drug response.
Micieli
G
G
Headache Center, Department of Neurology, C. Mondino Institute, University of Pavia, Italy. micieli@mondino.it
Cavallini
A
A
Marcheselli
S
S
Mailland
F
F
Ambrosoli
L
L
Nappi
G
G
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004877:Ergoloid Mesylates / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000209:etiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011433:Propranolol / Q000627:therapeutic use*; D016896:Treatment Outcome
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D004877:Ergoloid Mesylates; D011433:Propranolol