Dopamine levels fluctuate during a migraine attack, which may explain some of your symptoms.

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Anyone who has had a migraine attack knows it’s more than just a really bad headache. The pulsing pain in your forehead with every heartbeat, dizziness, or feeling of nausea can be debilitating.

Migraine disorder affects about 1 billion people yearly worldwide. Approximately 15% of people will experience migraine in any year, with women outnumbering men 3 to 1.

You’re also not alone in wondering if there’s a connection between dopamine levels and the condition. Research gives us some hints into how the “feel good” chemical may be playing a role in pain during a migraine attack.

Migraine is marked by episodes in various stages, including prodrome, aura, and headache phase or migraine attack.

The prodrome stage is when people feel a migraine attack coming on 1 to 2 days before it starts. Symptoms include energy changes — either up or down — and a stiff neck. If the person experiences migraine with aura, problems with vision, sensation, and speech may follow.

The attack phase is what many of us think about as migraine. People experience an extremely painful headache, from severe but steady to throbbing. Pain can also begin as mild and then worsen.

In addition to a debilitating headache, several other symptoms are common during a migraine attack, including:

  • nausea
  • vomiting
  • difficulty speaking
  • numbness or tingling
  • sensitivity to light and sound

Most migraine attacks last for 4 hours. Without treatment, they can last as long as a week and typically worsen before they get better.

Researchers aren’t sure what initiates a migraine attack, but they have some ideas. It’s possible that a sensory trigger — perhaps a strong smell, bright light, or stress — triggers an attack.

Dopamine is a neurotransmitter that’s released when you have a pleasurable experience. From going to a concert to having sex to finishing a major project at work, the rush of dopamine that follows is part of why you feel so satisfied — maybe even a little giddy.

Dopamine also plays a large role in movement and pain in the body. Dopamine concentration is high in the brain’s basal ganglia, which coordinates movement. It’s here that dopamine also dampens pain signals and sensory sensitivity.

With too little dopamine, sensory signals that are normally painless could become painful.

Scientists still aren’t sure what causes migraine, but there’s evidence that dopamine levels fluctuate during a migraine attack.

When people who experience migraine are in between attacks, their baseline dopamine levels are as stable as people who don’t have migraine attacks. Then, something triggers a change in dopamine and the sensitivity of dopamine receptors.

One study reports that 32.6% of people experience migraine with symptoms directly related to changes in dopamine levels, known as dopaminergic symptoms. Dopaminergic symptoms include yawning, fatigue, nausea, and mood changes.

Eventually, dopamine levels return to baseline, and the migraine attack is over.

After studying PET scans during different phases of a migraine attack, researchers suggest that dopamine drops going into an attack, possibly due to sensitivities to light, sound, and touch.

However, research has not yet shown a clear rise or drop in dopamine levels at specific times throughout migraine phases.

People who have migraine with dopaminergic symptoms have a more severe migraine, longer attacks, and more frequent allodynia (severe pain that comes with sensitivity to touch).

This is because reductions and imbalances in brain dopamine levels during migraine attacks increase a person’s pain, discomfort, and sensory sensitivity.

Common treatment for migraine: Dopamine blockers

While a full understanding of how migraine and dopamine are connected requires more study, migraine episodes are often treated in emergency rooms with dopamine blockers, also called dopamine antagonists.

A few of the most effective medications are chlorpromazine or prochlorperazine.

Can low dopamine cause migraine?

There’s a significant overlap between migraine and depression, sleep disorders, and attention deficit and hyperactivity disorder (ADHD), though the reason for the links is unclear.

Researchers are currently trying to figure out whether there is a common underlying mechanism causing migraine and these comorbid conditions, including an investigation of dopamine.

No current science shows low dopamine, seen in depression and sleep disorders, causes migraine.

Patients with midlife migraine with aura are more likely to be diagnosed with Parkinson’s disease, a movement-related condition caused by low dopamine in the basal ganglia.

People with migraine are also more likely to have tremors, tic disorders, and restless leg syndrome — all associated with low dopamine.

While the research shows ample overlap between migraine and low-dopamine conditions, the underlying cause is still unknown.

Until more research and scientists discover an underlying cause, medication, holistic treatments, and moderate exercise can help fend off migraine attacks.

The mechanisms causing migraine are not fully understood yet, which means that treatment may require trial and error — and patience.