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 Although
several dietary supplements are sometimes recommended for Migraine prevention,
those recommendations are mostly based on anecdotal evidence rather than
clinical trial results. With no medications on the market specifically developed
for Migraine prevention, the search for effective preventives is perpetual.
Along with the various prescription medications, "natural" products are of
significant interest to Migraineurs.
An open
label trial of coenzyme Q10 (CoQ10) as a Migraine preventive was very promising.1 The
results were published in Cephalalgia. The introduction to the article
states:
"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
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 Migraine without aura and Migraine
with aura.
The bottom line from this study:
"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
Hershey et al study:
Hershey et al conducted a study with the stated objective to, "This study
documents the prevalence of CoQ10 deficiency in migraine headache and examines
the potential effectiveness of supplementation." They found CoQ10 deficiency to
be common in pediatric and adolescent Migraineurs and supplementation to be
beneficial.2
What is Coenzyme Q10?
Coenzyme Q 10 is a compound that is made naturally in the body. The body
uses it for cell growth and to protect cells from damage. Animal studies have
shown that coenzyme Q10 helps the immune system work better and makes the body
better able to resist certain infections and types of cancer.3 Studies have shown
potential benefits of CoQ10 in treating Migraine disease, Parkinson's, heart
disease, type 2 diabetes, and other conditions. Statin drugs have been shown to
reduce natural levels of CoQ10, so it is sometimes recommended that patients
taking these drugs supplement CoQ10.
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 four medications actually been approved by the
FDA for Migraine prevention (Depakote, propranolol, timolol, and Topamax). The
Rozen et al trial of coenzyme Q10 is especially important
both because of it's excellent results and because it is for a Migraine
preventive rather than another Migraine abortive.
Dosages of 300 mg per day are now being recommended by many Migraine
specialists. It is recommended that the softgel form be used as CoQ10 is less
effective once powdered to make tablets and capsules.
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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.
2 Andrew D. Hershey MD, PhD, Scott W. Powers PhD, Anna-Liisa B.
Vockell RN, MSN, CPNP, Susan L. LeCates RN, MSN, CFNP, Priscilla L. Ellinor RN,
MSN, CPNP, Ann Segers RN, Danny Burdine BA, Paula Manning RN, Marielle A.
Kabbouche MD (2007). "Coenzyme Q10 Deficiency and Response to Supplementation in
Pediatric and Adolescent Migraine." Headache: The Journal of Head and Face
Pain 47 (1) , 73–80 doi:10.1111/j.1526-4610.2007.00652.x
3 Coenzyme Q10 (PDQ®). National Cancer Institute.
© Teri Robert, 2008
Last updated June 15, 2008
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