Therapeutic implications of modifying endogenous serotonergic analgesic systems.

Basic research strongly implicates the neurotransmitter serotonin as a modulator of endogenous analgesic systems. Recently, clinical strategies have been developed to activate endogenous serotonergic systems as a therapeutic approach to pain control. This paper reviews the biochemistry, anatomical distribution, and physiologic functions of serotonin. The evidence reviewed suggests that precursor loading to increase brain serotonin levels and administration of serotonin receptor inhibitors and serotonin receptor agonists may lead to novel methods of pain control and the development of useful analgesic drugs.