Serum prolactin and migraine.

Prolactin is a polypeptide, consisting of 198 amino acids, secreted from the anterior pituitary gland. Prolactin secretion is infl uenced by physiologic factors (sleep, pregnancy, stress, exercise, intercourse, nipple stimulation), pathologic factors (pituitary adenoma, primary hypothyroidism, renal failure, hypothalamic diseases), and drugs (phenothiazines, butyrophenones, morphine, estrogens, reserpine, methyldopa). Prolactin is unique because its secretion is controlled by a central inhibitory mechanism, mediated by dopamine.1,2 Migraine is a chronic, common disease that presents with mild to severe recurrent headaches, accompanied by autonomic and neurologic symptoms.1,4 Th ere are several explanations for the pathophysiology of migraine headache attacks. Scutari explained the pathogenesis of migraine headache with the dopamine hypothesis in 1977.1 In this hypothesis, prodromal, clinical and postdromal signs and symptoms of migraine headache are attributed to increased activity of the dopaminergic system.3-11,12 Administration of dopaminergic drugs can intensify the symptoms during an acute attack. Decreased levels of prolactin after increased secretion of dopamine would confi rm the accuracy of the above hypothesis. Considering this, we decided to measure the serum prolactin level during acute migraine attack in patients referred to Shahid Beheshti hospital and private neurologic clinic in 2002. On the base of the results, we demonstrate the role of increased dopaminergic activity as a major clue in migraine pathophysiology and we also can use the results for fi nding eff ective drugs for ameliorating the intensity of frequency of migraine attacks.