Migraineurs are always looking for methods to help prevent Migraine attacks. We would like to avoid medications as much as possible, and we're always concerned about the possible side effects. Over the years, in addition to countless medications, many Migraineurs have tried numerous vitamin, mineral, and herbal supplements. There are times when supplements work for some people. Unfortunately, more often than not, we see little if any decrease in the frequency or severity of Migraine Attacks.
An article in the April, 2002, issue of the Journal of the International Headache Society, Cephalalgia, reports very encouraging results from an open label trial of coenzyme Q10 as a Migraine preventive.1 The introduction to the article says:
"At
present there are very few efficacious migraine preventives and fewer without
significant side-effects. In medicine there has been a trend towards the
development of natural therapies that can be safely taken by all who suffer with
a disease regardless of age and past medical history. Migraine in particular is
a disorder of young people and this patient population is very resistant to
taking any form of medication, especially when it needs to be used on a daily
basis. Migraine can be a disabling disorder and migraine preventives have been
shown to not only reduce headache frequency, intensity and duration but also
improve quality of life. Coenzyme Q10 is a naturally occurring substance and
essential element of the mitochondrial electron transport chain. It has been the
most extensively studied agent for the treatment of mitochondrial disorders and
has been shown to have almost no identifiable side-effects in humans. There has
been a recent interest in the role that mitochondria may play in migraine
pathogenesis ... The objective of this investigation is to assess the efficacy
of coenzyme Q10 as a preventive treatment for migraine."1
Dosage and potential side effects:
The dosage recommended and used in the study is 150 mg of coenzyme Q10 daily. As for potential side effects, the study showed:
"In most instances coenzyme Q10 administration has been very well tolerated in doses up to 600mg per day, with an excellent side-effect profile. The most common side-effects pertain to the gastrointestinal system and include nausea, diarrhea, appetite suppression, heartburn and epigastric discomfort. In large studies the incidence of gastrointestinal side-effects is less than 1%."1
While a specific brand name was not preferred, one of the researchers did tell me in an interview that gel-caps are preferred as they contain a liquid form of Coenzyme Q10, which is thought to be better absorbed and utilized than powdered forms. As for
side effects, coenzyme Q10 has few, and rarely is the incidence of side effects
of any medication or supplement less than 1%. This is an excellent side effects
profile.
Key points from the trial:
- 61.3% of the patients in the trial achieved at least a 50% reduction in frequency of Migraine attacks by the end of the four-month trial.
- As with most Migraine preventives, it takes time to achieve optimum results. Data from the study suggest that it takes five to 12 weeks to achieve more than a 50% reduction.
- Coenzyme
Q10 is effective for both Classic Migraine (with aura) and Common Migraine
(without aura).
The bottom line:
"Coenzyme Q10 looks to be an
excellent choice for initial therapy for prevention of episodic migraine if
confirmed by controlled studies of efficacy. It can be given to almost any age
group without fear of significant side-effects."1
Summary:
Although research and development of Migraine abortives has made great strides in recent years, work on preventives has been woefully lacking. None of the medications used for Migraine prevention were originally developed specifically for that purpose, and trials of drugs being used off-label for Migraine prevention have been so few that only one drug has actually been approved by the FDA for Migraine prevention (Depakote). This trial of coenzyme Q10 is important both because of it's excellent results and because it is for a Migraine preventive rather than another Migraine abortive.
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Resources:
1 Rozen, TD, Oshinsky, ML, Gebeline, CA, Bradley, KC,
Young, WB, Shechter, AL & Silberstein, SD. "Open label trial of coenzyme Q10 as a migraine preventive." Cephalalgia 22 (2) 137-141.
