DOPAMINE AND MIGRAINE - A REVIEW OF PHARMACOLOGICAL, BIOCHEMICAL, NEUROPHYSIOLOGICAL, AND THERAPEUTIC DATA

The dopamine theory of migraine pathogenesis, first proposed by E Sicu teri in 1977, has attracted renewed interest after an increased freque ncy of the dopamine D2 receptor (DRD2) gene allele NcoI C was found in patients with migraine with aura. Therefore we reviewed the relevant literature. The most compelling argument favoring an interictal hypers ensitivity of dopamine receptors in migraineurs stems from pharmacolog ic studies of the gastric and autonomic effects of dopaminergic agents such as apomorphine, but none of these studies was blinded and placeb o-controlled Various DRD2 antagonists abort migraine attacks after par enteral administration, while there is circumstantial evidence that do pamine agonists may be useful for prophylaxis. Mosi. drugs used in the se trials, however, lack selectivity for dopamine receptors. Both in p harmacological and therapeutic studies most patients had migraine with out aura. We conclude that data suggesting a primary role for the dopa minergic system in migraine pathogenesis are unconvincing. Based on we ll established interactions between central amines, a reduced release of serotonin between attacks could lower dopamine release which would lead to receptor hypersensitivity.