Headache recurrence may be as high as 50 percent using 5-HT agonists alone. Dopamine and migraine Peroutka asks whether it is the increase in dopamine that triggers and maintains a migraine attack. Bromocriptine, a dopamine agonist, produces a predictable dose-related series of clinical signs. Yawning is the first to appear. Increasing the dose induces mood changes, nausea, gastrokinetic changes, hypotension, vomiting, and lastly dyskinesia.
Gastric dilatation occurs during a migraine attack.
The presence of dopamine receptors in the stomach helps explain the accompanying decrease in gastric tone, peristalsis, emptying, and disrupted gastroduodenal coordination. Dopamine antagonists reverse these effects. Open-label emergency room data suggest that injections of dopamine antagonists relieve acute migraine attacks.