Abstract
Ergot derivatives are the most effective compounds in the treatment of migraine attacks. It has been proposed that these compounds exert this effect by direct action on skull arteries or arteriovenous anastomoses, or by interfering with peripheral or central serotonin receptors. It is also possible that these compounds influence monoaminergic neurotransmission and, thereby, endorphins modulating the threshold for pain or sensory perception. In testing these hypotheses, changes in receptor sensitivity or function have to be considered since we have observed simultaneous tolerance and supersensitivity development in the same animal treated chronically with lisuride. We therefore propose that ergot derivatives can reduce the well documented higher sensitivity of migraine sufferers to various stimuli. In humans, prolactin-levels can be used for determining bioavailability of some ergot derivatives and for studying whether dopaminergic mechanism plays a role in their antimigraine effect.
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