Glover V, Jarman J, Sandler M
Department of Chemical Pathology, Queen Charlotte's and Chelsea Hospital, London, U.K.
J Psychiatr Res. 1993 Apr-Jun;27(2):223-31. doi: 10.1016/0022-3956(93)90010-y.
There is a considerable overlap in migraine and depression incidence, and both conditions may be associated with low levels of 5-hydroxytryptamine (5-HT). During a migraine attack there is evidence for low levels of platelet 5-HT and possibly also low Vmax for 5-HT uptake; both these findings are also associated with the depressed state. Both conditions can be treated by tricyclic and monoamine oxidase inhibiting antidepressants. However, there are also clear differences: migraine attacks are brief and self limiting. Part of the migraine cascade occurs outside the blood brain barrier, presumably involving blood vessels and, unlike depression, migraine attacks can be ameliorated by drugs which only act peripherally. In addition, migraine patients, especially males, often have permanently low levels of platelet monoamine oxidase activity, whereas patients with unipolar depression tend to have raised levels of this marker. This low enzyme activity may reflect part of the vulnerability to migraine, often associated in the prodromal phase with agitation or hyperactivity. Migraine may form part of a family of brief recurrent self-limiting disorders, which involve disturbances of both mood and monoamines; during the headache phase of the attack, the links with depression are most apparent.
偏头痛和抑郁症的发病率有相当大的重叠，而且这两种病症都可能与5-羟色胺（5-HT）水平低下有关。在偏头痛发作期间，有证据表明血小板5-HT水平较低，5-HT摄取的最大速度（Vmax）可能也较低；这两个发现也都与抑郁状态相关。这两种病症都可用三环类和单胺氧化酶抑制性抗抑郁药进行治疗。然而，两者也存在明显差异：偏头痛发作短暂且可自行缓解。偏头痛级联反应的一部分发生在血脑屏障之外，大概涉及血管，与抑郁症不同，偏头痛发作可用仅作用于外周的药物缓解。此外，偏头痛患者，尤其是男性，血小板单胺氧化酶活性往往长期处于较低水平，而单相抑郁症患者该标志物水平往往升高。这种低酶活性可能反映了偏头痛易感性的一部分，在偏头痛前驱期常伴有焦虑或多动。偏头痛可能是一组短暂复发性自限性疾病的一部分，这些疾病涉及情绪和单胺的紊乱；在发作的头痛期，与抑郁症的联系最为明显。
