Dopamine and migraine: a review

ABSTRACT

Dopamine has been incriminated to play a role in the pathophysiology of migraine headache since 1977 when Sicuteri proposed that a dopaminergic hypersensitivity exists in migraine. Lance pointed out that since nausea often precedes the headache, then changes in brainstem dopaminergic neurotransmission must be part of an attack. Dopamine receptor hypersensitivity in migraineurs, has been demonstrated by the induction of yawning, nausea, vomiting, hypotension, and other symptoms of a migraine attack by dopaminergic agonists at doses that do not affect nonmigraineurs. Conversely, dopamine receptor antagonists are effective therapeutic agents in migraine. Recent genetic data suggest that molecular variations within dopamine receptor genes play a modifying role in the pathophysiology of migraine with aura. Therefore, modulation of dopaminergic neurotransmission should be considered in the therapeutic management of migraine