The effect of naratriptan on cardiac autonomic
function in patients with migraine: a placebo
controlled pilot study
Ersel Onrat1, M. D., Associate Professor, Kayimi Kaya1, M. D., Associate Professor, Kemal Demirkirkan2, M. D., Associate Professor, Hulya Ellidokuz3, M. D., Associate Professor, Atac Celik1, M. D., Resident, Mehmet Melek1, M. D., Associate Professor
1Department of Cardiology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey 2Department of Neurology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey 3Department of Public Health, School of Medicine, Afyon Kocatepe University, Afyon, Turkey |
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Summary:
Aim. Naratriptan is a new member of the triptans which are used in aborting attacks of migraine. But
triptans may cause chest pain, myocardial infarction and arrhythmias in some patients. Naratriptan
shows antimigraine effect by activating 5HT1B/1D receptors. The activation of 5HT1B/1D receptors also
reduces the secretion of noradrenaline from cardiac sympathetic nerves. The effect of naratriptan on
cardiac autonomic function is not known. The aim of this study is to find out, if any the effect of
naratriptan on cardiac autonomic function by evaluating time and frequency domain parameters of
heart rate variability. Methods. Nine patients with migraine (8 women, mean age: 37±4 years) were
included in a pilot, double blinded, crossover and randomized study. All participants took 2.5 mg
naratriptan or placebo at least 5 days apart. Both time domain and frequency domain heart rate
variability (HRV) parameters were obtained during rest, controlled respiration and handgrip exercise,
before and 2 hours later naratriptan or placeboadministration. Results. BaselineHRVparameters were
similar before administration of naratriptan or placebo. Time domain parameters [and mean RR
interval, the standard deviation of R-R interval (SDNN) and the root mean square of successive R-R
interval differences (RMSSD)] and frequency domain parameters [low frequency (LF) and high frequency
(HF) spectral powers and LF/HF ratio] obtained after naratriptan administration were
not different when compared with placebo. Conclusions. A single dose 2.5 mg oral naratriptan administration
did not change sympathetic, parasympathetic reactivity and sympathovagal balance in migraneurs.
Key words:
migraine, naratriptan, heart rate variability, cardiac autonomic functions
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