Guglielmo Riccardo, Martinotti Giovanni, Di Giannantonio Massimo, Janiri Luigi
Department of Neuroscience, Catholic University of Rome, Rome, Italy.
Clin Neuropharmacol. 2013 Mar-Apr;36(2):65-7. doi: 10.1097/WNF.0b013e3182800271.
Migraine is a primary headache disorder characterized by recurrent episodes of headache associated with gastrointestinal, neurologic, and autonomic symptoms. Some evidence in literature suggests that the melatonergic system possibly plays an important role in the pathogenesis of migraine. Few studies have been performed on the use of melatonin as an antimigraine agent. Other than amitriptyline, few antidepressants have been found to be efficacious for migraine prophylaxis. Among antidepressants, agomelatine has a novel neurochemical mechanism. It is an melatonin receptor 1 and melatonin receptor 2 melatonergic receptor agonist and a selective antagonist of the 5-hydroxytryptamine (serotonin) receptor 2C receptors.
We report two cases of patients with migraine successfully treated with agomelatine; one patient presented with comorbid depression, whereas the other had no comorbidities.
Given its specific mechanism of action and similarity with melatonin, agomelatine may be a promising new treatment option for migraine prophylaxis. The potential therapeutic action of agomelatine could be due to its synergistic action on both melatonergic and 5-HT2C receptors.
偏头痛是一种原发性头痛疾病，其特征为反复发作的头痛，并伴有胃肠道、神经和自主神经症状。文献中的一些证据表明，褪黑素能系统可能在偏头痛的发病机制中发挥重要作用。关于使用褪黑素作为抗偏头痛药物的研究较少。除阿米替林外，很少有抗抑郁药被发现对偏头痛预防有效。在抗抑郁药中，阿戈美拉汀具有一种新的神经化学机制。它是褪黑素受体1和褪黑素受体2的褪黑素能受体激动剂，以及5-羟色胺（血清素）受体2C受体的选择性拮抗剂。
我们报告了两例使用阿戈美拉汀成功治疗的偏头痛患者；一名患者伴有抑郁症，而另一名患者无合并症。
鉴于其特定的作用机制以及与褪黑素的相似性，阿戈美拉汀可能是一种有前景的偏头痛预防新治疗选择。阿戈美拉汀的潜在治疗作用可能归因于其对褪黑素能和5-HT2C受体的协同作用。
