Stoica E, Enulescu O
Institute of Neurology and Psychiatry, Bucharest, Romania.
Rom J Neurol Psychiatry. 1993 Jan-Mar;31(1):11-9.
The effect of amitriptyline on catecholamine (CA) response to light of 20 migrainous patients was studied. The drug was given orally, 36 mg daily (12 mg x 3), for ten days. Before therapy, the migraineurs responded to light by an increase in epinephrine (E) excretion and not by the rise in norepinephrine (NE) excretion, noticed in controls. The NE excretion of migrainous subjects underwent very often a depression after photostimulation. Amitriptyline therapy prevented the post-photic rise in E excretion of migraineurs, without influencing significantly the variation in NE excretion produced in them by light. In other 8 migrainous subjects the effect of flunarizine, a selective calcium channel blocker, on CA response to light was tested. The dosage was of 5 mg daily, for ten days. Flunarizine had similar effects to those displayed by amitriptyline; the drug prevented the rise in E excretion produced by light without normalizing the NE response to light of migrainous subjects. The results suggest that the efficiency of these two drugs in migraine prophylaxis is connected with the ability of these substances to block the E discharge produced in migraineurs by light or by other stimuli. The interpretation is all the more likely as propranolol, another drug applied in migraine prophylaxis also blocks the post-photic E discharge of migraineurs.
研究了阿米替林对20例偏头痛患者儿茶酚胺（CA）对光反应的影响。药物口服给药，每日36毫克（12毫克×3），共十天。治疗前，偏头痛患者对光的反应是肾上腺素（E）排泄增加，而不像对照组那样去甲肾上腺素（NE）排泄增加。偏头痛患者的NE排泄在光刺激后常常降低。阿米替林治疗可防止偏头痛患者光刺激后E排泄增加，而对光引起的他们体内NE排泄变化无显著影响。在另外8例偏头痛患者中，测试了选择性钙通道阻滞剂氟桂利嗪对CA对光反应的影响。剂量为每日5毫克，共十天。氟桂利嗪具有与阿米替林相似的作用；该药可防止光引起的E排泄增加，而未使偏头痛患者对光的NE反应恢复正常。结果表明，这两种药物预防偏头痛的有效性与这些物质阻断偏头痛患者由光或其他刺激引起的E释放的能力有关。这种解释更有可能成立，因为另一种用于预防偏头痛的药物普萘洛尔也可阻断偏头痛患者光刺激后的E释放。
