Comparative effects of four migraine prophylactic drugs on an isolated extracranial artery.

Clonidine and methysergide constrict the rabbit auricular artery by activating smooth muscle alpha-adrenoceptors. Clonidine inhibits and methysergide enhances responses to stimulation of the sympathetic nerves. Both drugs sensitise the artery to a variety of vasoconstrictor stimuli, although not to potassium chloride. This weak generalised sensitisation may depend on clonidine and methysergide themselves being vasoconstrictor since sensitisation after clonidine did not occur when vasoconstriction was abolished with phentolamine. The marked potentiation of 5-HT and tryptamine observed during clonidine perfusion may reflect a property of the tryptamines since it was observed during perfusion with histamine but not when histamine vasoconstriction was abolished with mepyramine. Cyproheptadine and pizotifen neither constrict the artery nor sensitise it to vasoconstrictor agents. They inhibit responses to nerve stimulation, alpha-adrenoceptor agonists, potassium chloride and particularly histamine. Sensitisation of blood vessels reinforced by direct vasoconstriction may contribute to the mechanism of action of clonidine and methysergide in migraine. Conversely, alterations in vascular function may be less important to the antimigraine actions of either cyproheptadine or pizotifen.