Berilgen M S, Bulut S, Gonen M, Tekatas A, Dag E, Mungen B
Firat University School of Medicine, Department of Neurology, Elazig, Turkey.
Cephalalgia. 2005 Nov;25(11):1048-53. doi: 10.1111/j.1468-2982.2005.00956.x.
The tricyclic antidepressant amitriptyline (AMT) and the calcium channel blocker flunarizine are frequently used in the preventive treatment of migraine, but the side-effect of prominent weight gain that frequently emerges during preventive treatment of migraine with these agents often leads to the discontinuation of therapy. In this study, we aimed to investigate the possible relationship between the weight gain associated with the use of these agents and serum levels of leptin, C-peptide and insulin in patient with migraine. Forty-nine migraine patients with a body mass index (BMI) < 25 and without any endocrinological, immunological or chronic diseases were randomly divided into two groups, receiving AMT or flunarizine. There was a statistically significant increase in serum levels of leptin, C-peptide, insulin and measures of BMI in both groups when measured at the 12th week of therapy compared to their respective basal levels. To our knowledge this is the first study investigating the effects of AMT and flunarizine on serum leptin levels in preventive use of migraine treatment. A result from this study indicates that AMT and flunarizine may cause leptin resistance possibly by different mechanisms and thereby result in increase in serum leptin levels and BMI.
三环类抗抑郁药阿米替林（AMT）和钙通道阻滞剂氟桂利嗪常用于偏头痛的预防性治疗，但在使用这些药物进行偏头痛预防性治疗期间经常出现的显著体重增加副作用，常常导致治疗中断。在本研究中，我们旨在调查偏头痛患者使用这些药物所致体重增加与血清瘦素、C肽和胰岛素水平之间的可能关系。49名体重指数（BMI）<25且无任何内分泌、免疫或慢性疾病的偏头痛患者被随机分为两组，分别接受AMT或氟桂利嗪治疗。与各自的基础水平相比，在治疗第12周测量时，两组患者的血清瘦素、C肽、胰岛素水平及BMI测量值均有统计学意义的升高。据我们所知，这是第一项研究AMT和氟桂利嗪在偏头痛预防性治疗中对血清瘦素水平影响的研究。本研究结果表明，AMT和氟桂利嗪可能通过不同机制导致瘦素抵抗，从而导致血清瘦素水平和BMI升高。
