[Sulpiride in the prevention of migraine. A mechanism of hormonal interaction?].

In women migraine attacks are often related to hormonal changes and it has been demonstrated that migraine attacks correlate with falling plasma estrogen levels. Sulpiride, a benzamide derivative with neuroleptic and thymoleptic properties, is known to act at the hypothalamic level and in particular, to inhibit releasing factors responsible for follicle-stimulating hormone and prolactin secretion. In this way, sulpiride keeps estrogen levels low and prevents major fluctuations. 34 women and 6 men with classical, recurrent attacks of migraine were treated with sulpiride 300 mg/day, for several month and up to a two-year period. Of these, 55 percent became completely free of migraine, 20 percent improved, and the remaining 25 percent did not benefit. When sulpiride was withdrawn, migraine frequently recurred. Side effects were related to the above-mentioned hormonal changes: amenorrhea or delayed menstruation in 60 percent, breast tension in 40 percent and transient galactorrhea in 14 percent. Some weight gain was reported from allmost all patients.