Alpha-dihydroergocryptine and predictive factors in migraine prophylaxis

Objective: A double-blind, crossover study was carried out to compare the e fficacy of alpha -dihydrocrgocryptine mesylate (10 mg twice daily) vs propr anolol (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, br omocriptine) tests. Patients and methods: Forty migraineurs (10 males, 30 f emales) were randomized according to a two-period (3-month), two-treatment, crossover design. Efficacy was assessed using quantitative data recorded i n the patient's headache diary. Data were evaluated using the Wallenstein's method. Results: Both drugs showed a significant reduction in all the effi cacy variables (headache attacks, days with headache, analgesic consumption ) with no difference between treatments. Neither a bromocriptine test, nor a cold pressor test nor the symp tomato logical profile of individual migra ine attacks differed between the two groups of migraine patients. Ten patie nts experienced at least one adverse drug reaction during the first period of the crossover design, 5 being treated with alpha -dihydrocrgocryptine an d 5 with propranolol. Conclusions: It is concluded that a-dihydroergocrypti ne is an effective medication for migraine prophylaxis. The biochemical tes ts and the type of psychological profile cannot be used to predict drug res ponse.