1-Deprenyl Test in Migraine: Neuroendocrinological Aspects

Abstract

We evaluated the effect of l-deprenyl, a drug that increases the availability of endogenous dopamine, on the plasma levels of prolactin and growth hormone in 10 female patients with migraine and in 10 control subjects matched for age and menstrual phase. The patients showed a significant decrease in prolactin levels at 30, 60 and 120 min after the oral administration of 5 mg of l-deprenyl when compared with the values obtained in controls (p < 0.001). The effects of l-deprenyl on growth hormone plasma levels were not significantly different between patients and controls. These data suggest that l-deprenyl inhibits prolactin release in migraine patients, but not in control subjects. This differential sensitivity could be explained by dopamine receptor supersensitivity in migraine patients.

Dopamine and migraine

“…31 In general, headache is not a common, recognized side effect of direct dopamine agonists used in the treatment of Parkinson's disease. A dopaminergic receptor supersensitivity in migraineurs has also been demonstrated in neuroendocrinologic studies.…”

Authors' reply

“…Our literature search and paper review of this area have yielded the following: apart from our own study, of the peerreviewed controlled endocrine studies published in the literature since 1979, only two studies suggest DA hypersensitivity (17,18), whereas the other four (19)(20)(21)(22) suggest either normal or reduced DA sensitivity in migraine subjects between attacks. These studies have used drugs active at DA receptors as probes of DA function in attack-free migraineurs and have also reported conflicting findings.…”

Migraine and the Extrapyramidal System

“…All the above findings indicate that the dopaminergic system is clearly involved in migraine, but also reveal that the dopaminergic model of migraine, though fascinating, represents a working hypothesis at this stage. The dopaminergic hypersensitivity in migraineurs, demonstrated by numerous clinical and pharmacological studies (30, 51–57), to this day represents the strongest support for this hypothesis. Other issues deserve further investigation.…”

“… Activation threshold. Migraine patients are characterized by a condition of dopaminergic hypersensitivity, as demonstrated over the last 30 years by numerous pharmacological studies involving an acute challenge with levodopa, l ‐deprenyl and DA agonists (30, 51–55). Both pre‐ and post‐synaptic DA receptors in migraineurs are characterized by a lower activation threshold.…”