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SYNOPSIS

In the light of Sicuteri's central theory of migraine, reserpine-induced attacks have been related to a central depletion of monoamine stores, 5HT and DA in particular. Reserpine is known to increase serum prolactin (PRL) levels. The PRL response to reserpine, before and after treatment with drugs affecting DA and 5HT pathways, has been used as a tool to clarify the role of central neurotransmitters in migraine pathogenesis. Twenty-nine migraine patients and a control group underwent i.v. reserpine tests under control of PRL levels. A retest was performed after thirty days of treatment with bromocriptine, DL-5HTP or methysergide.

The reserpine-induced PRL increase was similar for migraine and control groups during the first 5 hours, with no relationship to occurrence and severity of headache. Only the control males, however, had returned to basal PRL levels after 24 hours. At the retest, only bromocriptine could prevent the PRL increase by reserpine and the onset of headache in nine out of ten patients. The value of the pharmacodynamic PRL secretions tests is emphasized in order to clarify the central mechanisms of various trigger factors in headache, and drug effectiveness in the management of migraine.