Available evidence indicates that
serotonin located within platelets--or lack of it--does not precipitate
migraine attacks, and that intravenously administered
serotonin is beneficial in
migraine. On this premise, it is not likely that the beneficial effect of intravenously administered
serotonin is due to replacement of lost intracellular
serotonin. If
serotonin is effective in relieving
migraine pain, this is probably due to extracellular
serotonin acting on the cardiovascular system. In other words,
serotonin-induced relief in
migraine is probably caused by the pharmacological properties of the
amine--it probably acts as a
drug and not by replacement. The
serotonin changes in
migraine are probably not primary, but caused by the disease process. Platelets may nevertheless be of importance in the pathogenesis of
migraine, and
serotonin may be of even more interest. However, interest in platelet
serotonin will probably be diminishing in the future.