Lai M, Loi V, Pisano M R, Del Zompo M
Department of Neurosciences B.B. Brodie, University of Cagliari, Italy.
Int J Clin Pharmacol Res. 1997;17(2-3):101-3.
Clinical and pharmacological evidences support the hypothesis of a hypersensitivity of dopamine (DA) receptors in migraine patients. The aim of our single-blind and placebo-controlled study is to evaluate the presence of this hypersensitivity and to desensitize the DA system with apomorphine, a classical DA receptor agonist. We studied six patients suffering from migraine without aura resistant to the prophylactic treatment and with high frequency of attacks. In these patients, we first tested individual sensitivity by a single i.m. low dose of apomorphine to assess the lowest effective dose to be administered s.c. in continuous infusion without side-effects. We used the response of growth hormone (GH) to apomorphine as a marker of DA2-receptor function. Clinical evaluation, blood pressure and heart rate were recorded before placebo or apomorphine administration and monitored every 15 min for 1 h after each injection. The treatment consisted of the continuous subcutaneous infusion of apomorphine for three weeks at the dosage previously assessed by the test. No difference in blood pressure and heart rate was found during test and treatment. The treatment was effective in reducing the frequency and the severity of migraine attacks.
临床和药理学证据支持偏头痛患者多巴胺（DA）受体超敏反应的假说。我们这项单盲、安慰剂对照研究的目的是评估这种超敏反应的存在，并使用经典DA受体激动剂阿扑吗啡使DA系统脱敏。我们研究了6例患有无先兆偏头痛、预防性治疗无效且发作频繁的患者。在这些患者中，我们首先通过单次肌内注射低剂量阿扑吗啡测试个体敏感性，以评估连续皮下输注且无副作用时要给予的最低有效剂量。我们将生长激素（GH）对阿扑吗啡的反应用作DA2受体功能的标志物。在给予安慰剂或阿扑吗啡之前记录临床评估、血压和心率，并在每次注射后每15分钟监测1小时。治疗包括按照测试先前评估的剂量连续皮下输注阿扑吗啡三周。在测试和治疗期间未发现血压和心率有差异。该治疗在降低偏头痛发作的频率和严重程度方面有效。
