Nicolodi M, Del Bianco P L, Sicuteri F
Interuniversity Centre of Neurochemistry and Clinical Pharmacology of Idiopathic Headache, Florence University, Italy.
Int J Clin Pharmacol Res. 1997;17(2-3):79-84.
5-HT is currently indicated to play a role in migraine (M). Previously evidenced 5-HT supersensitivity which characterizes M is insufficient to compensate for a possible deficit in 5-HT bioavailability. Inducing a further up-regulation of 5-HT receptor can yield improvement of M syndrome. Chronic treatments of methysergide and propranolol, drugs exerting antagonist action at 5-HT receptors, induced a significant amelioration in 256M sufferers. On the contrary, chronic treatments of ergotamine and sumatriptan, both provided with a 5-HT1 agonist activity, induced a worsening of M in 134 M sufferers. The M worsening was paralleled by an increase in consumption of analgesic drugs. Discussion concerns the effects of the chronically given 5-HT agonists and antagonists as well as the possible receptor mechanism underlying "craving for serotonin" in severe M. The increase of 5-HT supersensitivity evidenced at the end of M attacks is also discussed and its role in determining the interruption of the attack is here suggested.
目前认为5-羟色胺（5-HT）在偏头痛（M）中起作用。先前已证实的5-HT超敏反应是M的特征，但不足以弥补5-HT生物利用度可能存在的不足。诱导5-HT受体的进一步上调可改善M综合征。对256例M患者进行慢性治疗，使用在5-HT受体上具有拮抗作用的药物美西麦角和普萘洛尔，可显著改善症状。相反，对134例M患者进行慢性治疗，使用具有5-HT1激动剂活性的麦角胺和舒马曲坦，导致M症状恶化。M症状恶化的同时，镇痛药的消耗量增加。讨论了长期给予5-HT激动剂和拮抗剂的效果，以及重度M中“渴望血清素”潜在的受体机制。还讨论了在M发作末期证实的5-HT超敏反应的增加，并提出了其在决定发作中断中的作用。
