Migraine prophylaxis: A new approach

AbstractFrom previous research with migraine patients we know that there are abnormalities of platelet aggregation and adhesiveness. These abnormalities suggest that possibly platelet antagonists might prevent migraine attacks.Dipyridamole and aspirin are both platelet antagonists and are the two drugs used in this double blind study.The patients were randomly assigned to 4 treatment groups; 1. Dipyridamole, 2. Aspirin, 3. Dipyridamole plus Aspirin, and 4. Placebo. There were 40 patients in each group (160 total). These patients had either classical or common migraine, were male or female, and the age group was 21–65. No pregnant females were used. All patients had at least 3 migraine attacks per month prior to entry into the study.The patients received the study medication for 8 weeks following a 4 week washout period during which no prophylactic medication for migrain was used.The results show that the group of patients taking the combination of dipyridamole and aspirin had the greater decrease in both headache frequency and headache index. The dipyridamole group and the aspirin group had better results than the placebo group.The improvement in the 3 groups receiving the actual test medication had better results in the second month, than they did in the first month. This leads one to the conclusion that perhaps if the protocol for this study called for 3 months testing rather than 2, the results would be even better.Platelets are the smallest element found in the blood. In normal blood there are usually between 200, 000 to 400,000. This number is dependent upon a negative feedback mchanism which is modulated by thrompopoietin. The platelets are removed from the blood stream by the spleen and the liver after they have passed their normal life span, which is usually found to be from 8 to 10 days.Platelets contain granules. There are two types of granules, one is the amine storage granule, often called the platelet dense bodies. These granules contain ADP (adenosine dephosphate) ATP, SHT, mucopolysacarides, adrenalin, and calcium. The other type of granule is the alpha granule which contains lysomal enzymes and possibly fibrinogen.