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Alpha-dihydroergocryptine and predictive factors in migraine prophylaxis
G Micieli1, A Cavallini, S Marcheselli
1Headache Center, Department of Neurology, C. Mondino Institute, University of Pavia, Italy. micieli@mondino.it
Summary
Alpha-dihydroergocryptine mesylate and propranolol are equally effective for migraine prophylaxis, significantly reducing headache frequency and analgesic use. Predictors of treatment response were not identified through symptom profiles or autonomic tests.
Area of Science:
- Neurology
- Pharmacology
Background:
- Migraine without aura is a common neurological disorder.
- Prophylactic treatments aim to reduce migraine frequency and severity.
Purpose of the Study:
- To compare the efficacy of alpha-dihydroergocryptine mesylate versus propranolol for migraine prophylaxis.
- To identify predictors of therapeutic response using clinical and autonomic tests.
Main Methods:
- A double-blind, crossover study involving 40 migraineurs.
- Participants received alpha-dihydroergocryptine (10 mg BID) or propranolol (40 mg BID) for 3-month periods.
- Efficacy assessed via headache diaries and Wallenstein's method; autonomic function tested with cold pressor and bromocriptine tests.
Main Results:
- Both alpha-dihydroergocryptine and propranolol significantly reduced headache attacks, days with headache, and analgesic consumption.
- No significant difference in efficacy was observed between the two treatments.
- Bromocriptine tests, cold pressor tests, and symptomatological profiles did not predict treatment response.
- Adverse drug reactions were reported by 10 patients (5 on each drug).
Conclusions:
- Alpha-dihydroergocryptine mesylate is an effective option for migraine prophylaxis.
- Current biochemical and symptomatological assessments are insufficient to predict individual responses to these migraine prophylactic drugs.