Monro P, Swade C, Coppen A
Acta Psychiatr Scand Suppl. 1985;320:98-103. doi: 10.1111/j.1600-0447.1985.tb08083.x.
Evidence is reviewed indicating that instability in central nervous system handling of 5-hydroxytryptamine may be of primary importance in the pathogenesis of migraine, and that the observed diminution of platelet content and uptake of 5-hydroxytryptamine related to an attack may merely be a reflection of this. The rationale is discussed for selecting mianserin as a potentially effective migraine prophylactic based on: (i) its ability to restore to normal platelet 5-hydroxytryptamine uptake when this is decreased in depression; (ii) its effect on the central nervous system; and particularly (iii) its antiserotonergic activity. A double-blind control trial of mianserin versus placebo in the prophylaxis of migraine is described. There was a significant fall in both frequency and severity of migraine attacks when compared with baseline values in mianserin-treated patients but not in placebo-treated patients. There was no accompanying change on the Beck Depression Inventory. It is concluded that mianserin is an effective migraine prophylactic in some patients. There is no evidence indicating which pharmacological property of mianserin is responsible for this effect.
有证据表明，中枢神经系统对5-羟色胺处理的不稳定在偏头痛发病机制中可能至关重要，且观察到的与发作相关的血小板中5-羟色胺含量及摄取量的减少可能仅仅是对此的一种反映。基于以下几点讨论了选择米安色林作为潜在有效偏头痛预防药物的基本原理：（i）当抑郁症患者血小板5-羟色胺摄取量降低时，它能使其恢复正常的能力；（ii）其对中枢神经系统的作用；特别是（iii）其抗5-羟色胺能活性。描述了米安色林与安慰剂预防偏头痛的双盲对照试验。与米安色林治疗患者的基线值相比，偏头痛发作的频率和严重程度均显著下降，但安慰剂治疗患者未出现此情况。贝克抑郁量表无伴随变化。得出结论，米安色林对一些患者是有效的偏头痛预防药物。没有证据表明米安色林的哪种药理特性导致了这种效果。
