Dopamine antagonists and migraine

Migraine is common impairing disorder resulting from activation of the trigeminovascular system. Evidence suggests that dopaminergic mechanisms are important in migraine, including the premonitory phase. Dopamine antagonists have been used successfully as a primary therapy for migraine in urgent care settings and as adjuvant therapy on an outpatient basis. Experience and clinical studies have shaped the current use of dopamine antagonists, in particular prochlorperazine and metoclopromide. All commonly used dopamine antagonists have other receptor affinities that may also be important for efficacy and side effects. This review outlines the main dopamine antagonists used to treat migraine with supportive evidence and typical side effects.