TYRAMINE CONJUGATION DEFICIT IN MIGRAINE, TENSION-TYPE HEADACHE, AND DEPRESSION

This study was designed to investigate tyramine sulfate conjugation in patients with migraine or tension-type headache, as defined by the ne wly introduced International Headache Society (IHS) criteria and to ex amine whether this relationship is mediated by major depression. A tot al of 62 subjects completed the study: 38 with migraine (22 with aura and 16 without aura), 12 with tension-type headache, and 12 controls. Patients with migraine had significantly lower urinary tyramine sulfat e excretion following oral tyramine challenge than normal control. Ten sion-type headache was also associated with low tyramine conjugation, but only when comorbid with depression. Although mean tyramine sulfate output was lower among subjects with major depression within each of the subtypes of headache, no significant main effect emerged for depre ssion or major subtype thereof. The lower tyramine sulfate excretion v alues among patients with both migraine and depression compared to tho se of migraine alone or depression alone in our data and those of othe rs suggests that comorbid migraine with depression may represent a mor e severe form of migraine than migraine alone. These findings undersco re the importance of comorbidity in clinical and epidemiological studi es of migraine.