Prevention of the Last Chance: An Alternative Pharmacologic Treatment of Migraine

SYNOPSIS The hypothesis that in migraine, cyclically, an internal environment is established which - beyond a certain point-of-no-return - gives rise to the characteristic attack, led to the evaluation of the feasibility of short-term prevention of migraine attacks in patients who experience “warning” symptoms several hours before the actual attack. To interfere with the typical vegetative disregulation during the attack the selective dopamine receptor blocker domperidone was used. In a double-blind cross-over study 30 mg domperidone, taken at the very first appearance of the warning signals, was clearly superior (p<0.001) to placebo in preventing attacks: the success rates were 66% and 5% respectively.