Serotonin, the Carotid Body, and Cranial Vessels in Migraine

Lance, James W.; Anthony, Michael; Gonski, Alexander

doi:10.1001/archneur.1967.00470230105014

Cited by 64 publications

(34 citation statements)

References 22 publications

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“…Plasma serotonin level has been found to drop sharply at the onset of migraine headache and remain at a low level throughout the attack (Curran, Hinterberger, and Lance, 1965). Serotonin was shown to constrict scalp arteries (Lance, Anthony and Gonski, 1967), and it was postulated that methysergide may act in migrainous subjects by maintaining extracranial vasoconstriction on occasions when plasma serotonin falls (Lance, Anthony, and Somerville, 1970). Tricyclic antidepressants have been shown to increase serotonin levels in the rat brain but only in high dosage (Kivalo, Rinne, and Karinkanta, 1961).…”

Section: Discussionmentioning

confidence: 99%

Amitriptyline in migraine prophylaxis: Changes in pattern of attacks during a controlled clinical trial

Gomersall

Stuart

1973

Journal of Neurology, Neurosurgery & Psychiatry

173

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SUMMARY A double-blind controlled clinical trial of crossover design was conducted in 26 volunteers suffering from migraine. Of 20 subjects who completed the trial, 16 had fewer attacks on amitriptyline than on placebo. Amitriptyline was found to have the greatest effect in reducing attacks with a short warning and in which no specific cause could be recognized. It had least effect in attacks with a long warning and recognized as due to fatigue. The drug was effective only in reducing those attacks with shorter duration and its effect was irrespective of severity. A dosage of between 10 and 60 mg, usually taken at night, was found to be adequate.Amitriptyline has been found effective in chronic tension headache (Lance and Curran, 1964) and its beneficial use in migraine has been reported (Friedman, 1968;Mahloudji, 1969).Although its precise mode of action in migraine is uncertain, amitriptyline and the tricyclic antidepressants possess similarities in structure and pharmacological effect to some of the recently introduced prophylactic agents used in this condition. SELECTION OF SUBJECTSVolunteers were requested via the British Migraine Association and the press. The criteria of migraine used was the presence of intermittent headache with at least three of the following features: unilateral distribution, sensory prodromata, associated nausea; photophobia and throbbing.All subjects were asked to keep a record of their migraine attacks. These showed the information listed in Table 1. The charts were returned and discussed every two months with a statement as to their accuracy. It was indicated that attacks causing no disturbance of daily routine should be recorded as mild; those causing some lack of efficiency as moderate, and those causing complete disruption of usual activities should be recorded as severe.Of 114 volunteers, 94 were excluded as follows. Seventy-five were excluded before or during a 26 week control period. Only those subjects having more than two attacks per month and with over 50% described as at least of moderate severity were

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Section: Discussionmentioning

confidence: 99%

Amitriptyline in migraine prophylaxis: Changes in pattern of attacks during a controlled clinical trial

Gomersall

Stuart

1973

Journal of Neurology, Neurosurgery & Psychiatry

173

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“…Since serotonin is a potent constrictor of scalp arteries in man (Lance, Anthony, and Gonski, 1967), probably the fall of plasma serotonin permits the extracranial vasodilatation which is characteristic of migraine headache. In this case, how can antiserotonin agents exert any beneficial effect in the prophylaxis of migraine?…”

Section: Introductionmentioning

confidence: 99%

Comparative Trial of Serotonin Antagonists in the Management of Migraine

Lance¹,

Anthony²,

Somerville³

1970

BMJ

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“…2 It is interesting that the onset of headache in this patient occurred at a time when her barostatic responses were activated. G.: Or could something have happened to the carotid body?…”

Section: Patient: Nomentioning

confidence: 85%