Catecholamine (CA) response to exercise was studied in patients with common (16 cases) or classic (7 cases) migraine as well as in subjects with lumbar disc disease (20 control cases). In migrainous patients exercise induced constantly a rise in epinephrine (E) urinary excretion and a depression in norepinephrine (NE) excretion; the post-exercise E excretion represented the double or the treble of basal E excretion. In controls the pattern of CA response to exercise was opposite to that noted in migraineurs: the exercise induced in almost all controls an augmentation in NE excretion and a depression in E excretion. The pattern of CA response to exercise of migrainous patients is similar to that noted in them after light exposure. As such patients responded by an E discharge to both exercise and light exposure, two conditions preceding quite often the onset of migraine attack, the data suggest the participation of this biochemical abnormality in the pathogeny of migraine. The interpretation is also supported by our previous data demonstrating that the antimigraine drugs are able to prevent the E discharge induced in migrainous patients by light exposure.

Adult↗

PubMedDate not supplied

The influence of amitriptyline and flunarizine on catecholamine response to light in patients with migraine.

The effect of amitriptyline on catecholamine (CA) response to light of 20 migrainous patients was studied. The drug was given orally, 36 mg daily (12 mg x 3), for ten days. Before therapy, the migraineurs responded to light by an increase in epinephrine (E) excretion and not by the rise in norepinephrine (NE) excretion, noticed in controls. The NE excretion of migrainous subjects underwent very often a depression after photostimulation. Amitriptyline therapy prevented the post-photic rise in E excretion of migraineurs, without influencing significantly the variation in NE excretion produced in them by light. In other 8 migrainous subjects the effect of flunarizine, a selective calcium channel blocker, on CA response to light was tested. The dosage was of 5 mg daily, for ten days. Flunarizine had similar effects to those displayed by amitriptyline; the drug prevented the rise in E excretion produced by light without normalizing the NE response to light of migrainous subjects. The results suggest that the efficiency of these two drugs in migraine prophylaxis is connected with the ability of these substances to block the E discharge produced in migraineurs by light or by other stimuli. The interpretation is all the more likely as propranolol, another drug applied in migraine prophylaxis also blocks the post-photic E discharge of migraineurs.

Amitriptyline↗

PubMedDate not supplied

A new trend in the therapy of orthostatic arterial hypotension: prevention by propranolol or metoclopramide of the excessive adrenaline release of brainstem infarct patients with postural hypotension.

The catecholamine (CA) response to upright posture was studied in 30 brainstem infarct patients with orthostatic arterial hypotension; the investigation was made before and after 10 days propranolol therapy (in 15 cases) and before and after 10 days metoclopramide therapy (in other 15 cases). Before treatment almost all patients responded to posture by a rise in adrenaline (A) excretion and by a depression in noradrenaline (NA) excretion. Propranolol therapy prevented the excessive A release produced by standing and normalized their NA response to posture. Metoclopramide administration also prevented the post-orthostatic A discharge but had no significant influence on NA response to posture. Both drugs exerted a favourable influence on postural hypotension of investigated patients. As post-orthostatic A discharge observed in patients with postural hypotension is involved in the pathogeny of this syndrome and both metoclopramide and propranolol are able to correct this disorder one may maintain that the clinical favourable results obtained with these drugs are ascribable at least partly to their blocking effect on A release.

Antiemetics↗