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Anterior Pituitary Hormone Secretion During Treatment With Flunarizine In Migraineous Patients

Introduction Govoni et+al. reported that flunarizine and nifedipine inhibited the K induced (but not basal) dopamine release in striatal slices of rat brains previously submitted to hypoxic conditions (1). Moreover Drago et al. reported an increase of PRL levels in old but not in young) rats chronically treted with flunarizine. In both young and old rats these Authors observed an increase of the percentage of animals that froze during acquisition session, a behavior similar to that observed in rats treated with antidopaminergic drugs such as haloperidol (2). In post-menopausal cephalalgic women Facchinetti et al. observed an increase of PRL plasma levels after 60 days of treatment with flunarizine (10 mg daily) (3). Cortelli et al. observed a reduction of GH responses to arginine test and an enhancement of PRL response to TRH (though basal levels of PRL were unchanged) in cephalalgic children treated with flunarizine (5 mg daily) for a month (4). Interestingly enough, the onset of depressive symptomatology during chronic treatment with flunarizine is also reported, particularly in patients with personal or familiar history of depression. The aim of the study was to evaluate plasma levels of anterior pituitary hormones which are influenced by hypothalamic dopamine, such as PRL, FSH, LH, GH and TSH, and to correlate the hormone modifications with drug side effects. Materials and Methods 20 patients (13 female, 7 males, mean age: 39.242 6.26) suffering from classic or common migraine and cluster headache (2 male patients), according to diagnostic criteria of Ad Hoc Committee for classification of headache (6), were admitted to the study. Exclusion criteria were: 1)presence of endocrinological disorders; 2)occurrence of more than 12 migraine attacks in a month; 3)presence of interparoxismal headache. Three out of all females were in post-menopausal age. As a control group 10 migraineous patients (5 females and 5 males), mean age: 41.5+ 6.43) were admitted to the study and treated with placebo for-2 months. After information of trial conditions, all patients observed a