Serotonin: A key to migraine disorders?

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Are pounding headaches caused by too much blood flooding the brain? Or too little? What tells the blood vessels to contract and expand? Scientists now consider serotonin, a brain chemical, to be a crucial factor.

David E. Comings, M.D., in his classic work Tourette Syndrome and Human Behavior, postulates that low serotonin levels might cause blood vessels to dilate and cause migraine.

His reasoning involves side effects of the drug reserpine, and reserpine treatment results in the depletion of brain serotonin. "These headaches," he writes, "are relieved by the injection of serotonin or its precursor, 5-hydroxytryptophan. Blood serotonin drops during migraine headaches. This is followed by an increase in 5-HIAA in the urine. MAO inhibitors, which increase serotonin in the synapses, prevent migraine headaches, and medications that stimulate serotonin S1 receptors relieve the acute pain. Migraine sufferers often report that the headaches stop after they have vomited. Vomiting stimulates intestinal motility and raises blood serotonin.

"All of these facts suggest that low serotonin levels may predispose to migraine headaches. The observation that migraine headaches are common in Tourette syndrome supports the proposal that Tourette syndrome may be due to a defective production of serotonin.

"Tension headaches are also associated with a blood serotonin level that may be even lower than in individuals with migraine headaches."

Serotonin is a neurotransmitter in the brain. A neurotransmitter acts as a chemical messenger, a means of communication that determines sleep patterns, appetite, blood flow, and countless other functions.

The search for a cure for migraine may be found in drug therapy, which can help to control production of serotonin. Some success has been achieved in moderating the ebb and flow of the hormone with regard to depression, panic disorder, Tourette syndrome, and obsessive-compulsive disorders.

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Hunger, fatigue, stress, food, and light can affect serotonin levels, that can fall as a result of stress and low blood sugar. Serotonin levels can rise as a result of foods containing amines, such as cheese, chocolate and oranges. Foods containing amino acids such as tryptophan (milk, dairy foods) can affect increase of serotonin flow.

Serotonin is affected by hormones. An increase in the female hormone estrogen triggers an increase in serotonin. Birth control pills containing estrogen produce headaches when serotonin levels fall in pill free days. (A drop in estrogen levels during menstruation produces a decrease in serotonin, which can bring on migraine because blood vessels dilate.)

PHOTO: David E. Comings, M.D.

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By David E. Commings, M.D.

Author of Tourette Syndrome and Human Behavior Published by The Hope Press, P.O. Box 188, Duarte, California 91009. Price: $49.95 hardcover, $39.95 softcover.

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