An open trial of buspirone in migraine prophylaxis. Preliminary report.

Because of evidence that supports an important role for the 5-HT1A receptor subtype in migraine, buspirone--the novel 5-HT1A receptor agonist with anxiolytic properties--was given to 33 patients suffering from severe migraine exacerbations. Patients took 15-20 mg/daily for 10 weeks; six (18%) patients did not improve. Although buspirone was well tolerated, two additional patients (6%) did not finish the trial, due to undesirable side effects. On the other hand, 25 (76%) patients improved; 17 (52%) exhibited an excellent response; and 8 (24%), a moderate response. Potential reasons for the observed antimigraine effect of buspirone and its possible consequences in migraine pathophysiology are discussed. Our results, at first, seem to support the role of a 5-HT1A hypersensitivity in migraine pathogenesis, and warrant further trials to confirm whether buspirone represents an alternative in preventive treatment of migraine exacerbations.