Amine turnover in migraine

Excretion of the vaso-active amines tyramine, serotonin, noradrenaline, adrenaline and histamine and blood levels of serotonin, noradrenaline, adrenaline and histamine, were estimated in 10 patients before, during and after an attack of migraine. During the headache process there was a statistically significant fall in the excretion of tyramine and a similarly significant rise in the excretion of serotonin. Excretion of the other 3 amines showed no significant fluctuation during the various phases of the migraine attack. Blood levels of serotonin were significantly lower during headache than during freedom from headach. whilst whole blood histamine was significantly higher only during the postheadach phase. The meaning of the latter observation is not obvious. The above results are discussed in the light of recent reports that tyramine is the substance responsible for headache attacks in patients who have a history of dietary migraine. Reasons are offered as to why this is unlikely to be the case.