Basal plasma HGH and cortisol levels and the effect of clonidine administration in female migrainous patients.

Clonidine, a central alpha-adrenergic agent and prophylactic antimigraine drug is known to stimulate human growth hormone (HGH) release and to suppress cortisol secretion. A possible association between basal hormonal levels and response to either acute clonidine test or chronic treatment in female migrainous patients was investigated. 15 females, aged 18-43 years, suffering from migraine, underwent an acute clonidine test by administration of a single oral dose of 0.15 mg. High basal HGH levels (greater than or equal to 9 ng/ml) were observed in 6 patients, while the other 9 patients demonstrated normal low basal HGH levels. Acute clonidine administration induced a marked rise of HGH in 8 of the 9 patients with low basal HGH. In 4 of the 8 responders HGH levels exceeded 20 ng/ml and 3 subjects reached the acromegalic range (greater than 90 ng/ml). The mean response in this group was higher than in a reference group consisting of children and adolescents. It is suggested that the basal hypersecretion and the hyperresponsiveness of HGH to clonidine provocation test in some migrainous patients results from a hypersensitivity of the central alpha-adrenergic receptors. 12 of the 15 females were treated for 10 weeks with clonidine at gradually increased doses of 0.05 mg/day up to a maximal dose of 0.15 mg/day. A marked suppressive effect on cortisol secretion was observed in the migrainous patients after acute and chronic administration of clonidine. No correlation was observed between HGH and cortisol response to acute or chronic clonidine administration and the prophylactic effect of clonidine on migraine.