Question on Guidelines: Are There Additional Complementary Treatments for the Prevention of Episodic Migraine?
LarryCharleston IV, Physician, Director SHMG's Comprehensive Headache Care Center, Spectrum Health Medical Group- Neuroscience Divisiondr_lciv@hotmail.com
Larry Charleston IV, Grand Rapids, MI, USA
Submitted May 07, 2012
Silberstein et al. highlighted the evidence of complementary treatments for the prevention of episodic migraine. [1] There are a few natural supplements used in the prevention of migraine or its associated symptoms that were not classified in these guidelines. A review of additional natural supplements may be worthy of examination and classification based on their respective evidence.
• Alpha Lipoic Acid (Thioctic Acid): One underpowered randomized control trial 600mg/day strong trend for decrease monthly attack frequency (p=0.06). Within group analysis showed significant reduction in attack frequency, headache days, and headache severity in the treatment group. [2]
• Vitamin E: It has been demonstrated that Vitamin E effectively reduced the severity of headache pain, abortive headache medication usage, functional disability, and associated migraine symptoms (phonophobia, photophobia, and nausea) in pure menstrual migraine in a randomized controlled trial. [3] The authors recommended a dosage of 400IU for five days starting two days prior to menses.
• Ginko Biloba: In an open, preliminary trial, a combination of 60 mg ginkgo biloba terpenes phytosome, 11 mg coenzyme Q 10, and 8.7 mg vitamin B2 (Migrasoll) was effective in reducing both aura frequency and duration in the study population. [4]
1. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman, E. Evidence-Based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults. Neurology 2012;78;1346-1353.
2. Magis D, Ambrosini A, S'andor P, Jacquy J. Laloux P, Schoenen, J.
A Randomized Double-Blind Placebo-Controlled Trial of Thioctic Acid in Migraine Prophylaxis. Headache 2007; 47:52-57.
3.Ziaei S, Kazemnejad A, Sedighi A, The effect of vitamin E on the treatment of menstrual Migraine. Med Sci Monit, 2009; 15(1):CR16-19 Available at: www.medscimonit.com/fulltxt.php?ICID=869523 Accessed on August 23, 2009.
4. D'Andrea G, Bussone G, Allais G, et al. Efficacy of Ginkgolide B in the prophylaxis of migraine with aura. Neurol Sci, 2009; 30(Suppl 1):S121-S124.
For disclosures, contact editorial office at journal@neurology.org.
Silberstein et al. highlighted the evidence of complementary treatments for the prevention of episodic migraine. [1] There are a few natural supplements used in the prevention of migraine or its associated symptoms that were not classified in these guidelines. A review of additional natural supplements may be worthy of examination and classification based on their respective evidence.
• Alpha Lipoic Acid (Thioctic Acid): One underpowered randomized control trial 600mg/day strong trend for decrease monthly attack frequency (p=0.06). Within group analysis showed significant reduction in attack frequency, headache days, and headache severity in the treatment group. [2]
• Vitamin E: It has been demonstrated that Vitamin E effectively reduced the severity of headache pain, abortive headache medication usage, functional disability, and associated migraine symptoms (phonophobia, photophobia, and nausea) in pure menstrual migraine in a randomized controlled trial. [3] The authors recommended a dosage of 400IU for five days starting two days prior to menses.
• Ginko Biloba: In an open, preliminary trial, a combination of 60 mg ginkgo biloba terpenes phytosome, 11 mg coenzyme Q 10, and 8.7 mg vitamin B2 (Migrasoll) was effective in reducing both aura frequency and duration in the study population. [4]
1. Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman, E. Evidence-Based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults. Neurology 2012;78;1346-1353.
2. Magis D, Ambrosini A, S'andor P, Jacquy J. Laloux P, Schoenen, J. A Randomized Double-Blind Placebo-Controlled Trial of Thioctic Acid in Migraine Prophylaxis. Headache 2007; 47:52-57.
3.Ziaei S, Kazemnejad A, Sedighi A, The effect of vitamin E on the treatment of menstrual Migraine. Med Sci Monit, 2009; 15(1):CR16-19 Available at: www.medscimonit.com/fulltxt.php?ICID=869523 Accessed on August 23, 2009.
4. D'Andrea G, Bussone G, Allais G, et al. Efficacy of Ginkgolide B in the prophylaxis of migraine with aura. Neurol Sci, 2009; 30(Suppl 1):S121-S124.
For disclosures, contact editorial office at journal@neurology.org.