Efficacy of Buspirone Hydrochloride in Migraineurs with Anxiety: a Randomized Double Blind, Parallel Group, Placebo-controlled Study.
- Author:
Soon Tae LEE
1
;
Manho KIM
Author Information
1. Department of Neurology, Seoul National University College of Medicine, Seoul, Korea. kimmanho@snu.ac.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Buspirone;
Migraine;
Anxiety disorder;
5-HT1A
- MeSH:
Anti-Anxiety Agents;
Anxiety Disorders;
Anxiety*;
Buspirone*;
Diagnosis;
Headache;
Humans;
Migraine Disorders;
Outpatients;
Receptor, Serotonin, 5-HT1A
- From:Journal of the Korean Neurological Association
2004;22(4):328-333
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Migraine is commonly associated with anxiety disorder. However, whether anxiolytic medicine or changes in anxiety levels affect the migraine attack is unclear. Buspirone, the agonist for 5-HT1A receptor, is effective in treating generalized anxiety disorder. In this study, we attempted to test the efficacy of buspirone for migraine combined with anxiety disorder. METHODS: 111 outpatients aged 20 to 70 years (mean, 46.4; SD, 12.8), were analyzed. The diagnosis of migraine was made according to the HIS (International Headache Society) criteria, and the level of anxiety was rated by the Hamiton Anxiety Rating Scale (HAM-A). The migraineurs were randomly assigned to treatment with either buspirone (15 mg/day) or placebo for 6 weeks. The efficacy variables included changes in headache frequency, headache intensity, Headache Index, Headache Management Self-Efficacy Scale (HMSE), Headache Disability Inventory (HDI), and the Hamilton Anxiety Rating Scale (HAM-A). The correlation between headache improvement and the anxiolytic effect were analyzed. RESULTS: Headache frequency showed a 43.3% reduction (from 6.7/2 weeks to 3.8/2 weeks) in the buspirone-treated group, whereas a 10.3% reduction (from 6.8 to 6.1/2 weeks) in the placebo group. The Headache Index, HDI, and HAM-A were also significantly lowered in buspirone-treated patients than in placebo-treated patients. However, the headache intensity or the HMSE score were not changed. Correlation analysis between the change of Headache Index and that of HAM-A revealed no significant association. CONCLUSIONS: Buspirone is an effective prophylactic agent in migraine combined with anxiety disorder. This prophylactic effect is not secondary to the anxiolytic effect. This suggests that the agonistic action for 5-HT1A is primarily effective in migraine prophylaxis.