Nutraceuticals in Migraine: A Summary of Existing Guidelines for Use

  title={Nutraceuticals in Migraine: A Summary of Existing Guidelines for Use},
  author={Thilini Rajapakse and Tamara Pringsheim},
  journal={Headache: The Journal of Head and Face Pain},
The use of nutraceuticals or food/herbal products for health benefits is expanding in adults with migraine as they seek relief from pain in an effective and tolerable manner not always afforded by current conventional pharmacologic therapies. Guidelines from the American Academy of Neurology/American Headache Society, Canadian Headache Society, and European Federation of Neurological Societies have discussed nutraceuticals in varying degrees of detail with at times conflicting recommendations. 

Complementary and Integrative Health Treatments for Migraine.

  • Palak PatelM. Minen
  • Medicine, Psychology
    Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
  • 2019
This article should provide an appreciation for the wide range of nonpharmacologic therapies that might be offered to patients in place of or in addition to migraine-preventive medications.

Complementary and Alternative Approaches to Chronic Daily Headache: Part III—Nutraceuticals

In this chapter, the research evidence for nutraceuticals for primary headache disorders is described and several supplements have Level B evidence of efficacy according to the 2012 American Headache Society and the American Academy of Neurology guidelines.

An Integrative Approach to Pediatric Headache Management: Nutraceuticals

Purpose of ReviewThe aim of this paper is to familiarize readers with the breadth of nutraceutical options available to patients that may empower autonomous headache management and lessen headache

The Efficacy of Herbal Supplements and Nutraceuticals for Prevention of Migraine: Can They Help?

It is concluded that herbal supplements and nutraceuticals help reduce the frequency of migraine headaches; however, mixed results were seen regarding the severity and duration of headaches.

Phytomedicines in the Treatment of Migraine

The evidence for feverfew is mixed; butterbur is effective with potential risks of hepatotoxicity related to preparation; marijuana has not been shown to be effective in migraine treatment, and data are scant; Saint John’s Wort shows relevant physiological activity but is a hepatic enzyme inducer and lacks clinical studies for this purpose; the Damask rose when used in topical preparations did not show efficacy in one clinical trial.

Review on Headache Related to Dietary Supplements

The lifetime prevalence of headaches is 96%. Approximately 11% of the adult population worldwide has a migraine headache. Migraine is a complex disorder that is more than a simple headache. So far,

Nutraceuticals and Behavioral Therapy for Headache

The body of evidence for nutraceutical and behavioral CAM interventions for headache continues to grow and improve in quality and should be examined against current standards of headache care.

Non-Pharmacological Approaches for Migraine

The most recent and evidence-based advances in non-pharmacological therapeutic approaches for migraine are discussed, offering alternatives to drug treatment for both the commonly encountered episodic cases as well as the more complex migraine phenotypes, which are capable of challenging even the headache specialist.

Behavioral Approaches to CDH: Evidence and Outcomes

The evidence that supports current practice recommendations for managing chronic daily headache is focused on and limitations where further research is warranted are highlighted.

Complementary and integrative medicine in the management of headache

The overall quality of the evidence for CIM in headache management is generally low and occasionally moderate, and available evidence suggests that traditional Chinese medicine including acupuncture, massage, yoga, biofeedback, and meditation have a positive effect on migraine and tension headaches.



An evidence-based review of oral magnesium supplementation in the preventive treatment of migraine

  • L. TeigenC. Boes
  • Medicine, Psychology
    Cephalalgia : an international journal of headache
  • 2015
The strength of evidence supporting oral magnesium supplementation is limited and a more advantageous alternative to magnesium supplementation, in patients willing to make lifestyle changes, may be to focus on increasing dietary magnesium intake.

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society

A review of the literature on the use of butterbur extract for migraine prophylaxis and concludes that it has the potential for serious toxicity and Dr. Mauskop's interpretation is concluded.

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults

New evidence-based recommendations for the preventive treatment of migraine headache are provided and petasites (butterbur) is effective for migraine prevention and should be offered to patients with migraine to reduce the frequency of migraine attacks.

Nutraceuticals and Headache: The Biological Basis

The biological basis for non‐conventional or non‐mainstream approaches to the treatment of migraine, and the science when known related to the potential genetic susceptibility and sensitivity to these treatments are reviewed.

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the quality standards subcommittee of the American Academy of Neurology and the American Headache Society

The evidence of complementary treatments for the prevention of episodic migraine has been highlighted and a review of additional natural supplements may be worthy of examination and classification based on their respective evidence.

Canadian Headache Society guideline for migraine prophylaxis.

There is good evidence from randomized controlled trials for use of a number of different prophylactic medications in patients with migraine, and medication choice for an individual patient requires careful consideration of patient clinical features.

Patients' Preference for Migraine Preventive Therapy

Patients' preferences for migraine preventive treatment have never been studied, so physicians should understand patients' treatment preferences and select drugs that most closely meet their patients' needs.

Effectiveness of high‐dose riboflavin in migraine prophylaxis A randomized controlled trial

Because of its high efficacy, excellent tolerability, and low cost, riboflavin is an interesting option for migraine prophylaxis and a candidate for a comparative trial with an established prophyllactic drug.

Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial

CoQ10 was superior to placebo for attack-frequency, headache-days and days-with-nausea in the third treatment month and well tolerated; 50%-responder-rate for attack frequency was 14.4% for placebo and 47.6% for CoQ10 (number-needed-to-treat: 3).

Prophylaxis of Migraine with Oral Magnesium: Results From A Prospective, Multi-Center, Placebo-Controlled and Double-Blind Randomized Study

High-dose oral magnesium appears to be effective in migraine prophylaxis and duration and intensity of attacks and the drug consumption per attack tended to decrease compared to placebo but failed to be significant.