[Pilot studies with a serotonin agonist (AH 25086 B). Efficacy and tolerance in acute migraine attacks.]

AH 25086 B is a selective agonist of the newly determined 5-HT(1) receptors, which are sited mainly in the intracranial section of the carotid artery. According to experimental studies, the effect of AH 25086 B is decidedly more highly selective than that of ergotamine; the blood flow through the arteriovenous anastomoses of the internal carotid artery is clearly reduced, while the blood flow through the capillaries supplying the brain is increased. With AH 25086 B administered in an infusion rapid abolition of migraine attacks already in progress proved possible. The first 12 patients worldwide to receive this preparation were treated, some on several occasions, for a total of 21 migraine attacks: 7 received one infusion, 3 received two, 1 three, and 1 patient received five infusions. There were some side-effects with some infusions: nausea (18), vomiting (9), and photophobia (19). On average it took 31 min (range 10-60 min) for the headache to be relieved, regardless of the duration of migraine symptoms before the start of treatment. This was not a controlled study, but the results (14 very good, 6 good or satisfactory, in 21 attacks treated) were better than could have been expected by chance. Tolerance of the preparation was good, all side-effects being transitory and mild; with dosages up to 1.6 mug kg(-1) min(-1) no changes were seen in heart rate or blood pressure.