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Migraine Patients May Benefit From Magnesium or CoQ10


 

RANCHO MIRAGE, CALIF. – Alternative therapies are not a replacement for prescription drugs in migraine treatment, but they can reduce the severity of the attacks and help ease symptoms, reported Dr. Alexander Mauskop.

In fact, “anyone suffering from migraines can benefit from these treatments,” Dr. Mauskop said. The most important point, he stressed at a meeting sponsored by the Diamond Headache Clinic, is that nonpharmacologic methods can be as effective as drugs, if not more effective. When instituting an alternative approach, the first step is to eliminate food triggers, encourage a proper sleep regimen, regular meal intake, and sufficient hydration.

Actual alternative therapies to control physiologic response to stress include regular aerobic exercise and biofeedback, said Dr. Mauskop, director of the New York Headache Center.

For migraines, the most commonly used supplements are magnesium, feverfew, coenzyme Q 10 (CoQ10), riboflavin, butterbur extract, and alpha lipoic acid.

The most important supplement, according to Dr. Mauskop, is magnesium. “It's known that up to 50% of people with acute migraine have a magnesium deficiency. … It is much more effective to treat them with a product they're deficient in rather than using drugs,” he said. Magnesium is “very effective for 50% of those who are deficient in it, but even prescription drugs work for only 50% of migraineurs” (Headache 2003;43:601–10).

Research has found that, for migraine, CoQ10 at 300 mg/day is effective, and that for Parkinson's disease 1,200 mg/day is effective. “Riboflavin has similar function in the body as CoQ10 and was shown to prevent migraine in one double-blind study. Although the therapeutic amount of riboflavin is very high–400 mg/day; many multivitamins have only 2–3 mg,” he said (Neurology 1996;50:440–66).

Butterbur, 50 mg t.i.d, has also been found to help treat migraine, most likely due to its anti-inflammatory properties, or “maybe something else. Herbal products contain hundreds of chemicals and we can only guess which are the active ones” (Neurology 2004;63:2240–4).

Dr. Mauskop recommends a combination of magnesium, feverfew, and riboflavin: “I find that about half of people are very happy with [this combination]. Sometimes their headaches completely disappear so that they don't need prescription drugs.”

The triple combination, available as MigreLief, costs $18 per month, and “if money is not an issue, I add CoQ10.” Patients take 300 mg/day of MigreLief for 8 weeks. Although one study that showed favorable results in migraine patients used 100 mg t.i.d., “I often recommend 300 mg once daily due to adherence issues.”

Patients have a continuum of responses. “Some say their headaches are more responsive to prescription drugs and some have total disappearance of migraines, with most responses somewhere in the middle,” he said.

Butterbur has only one manufacturer, Dr. Mauskop said, “but feverfew is sold by many companies and the products are not always of good quality. Patients need to buy recognized brands or the triple combination supplements.” Dr. Mauskop is a paid consultant to Quantum, Inc., the manufacturer of MigreLief.

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