COENZYME Q10 IN MIGRAINE PROPHYLAXIS THERAPY
In an open-label trial, researchers at the Cleveland Clinic Headache Center tested coenzyme Q10 for migraine prophylaxis through a possible role of disturbances in mitochondrial energy metabolism in migraine headches. Migraineurs were given a supplement dose of 150mg/day. 61% had a greater than 50% reduction in number of days with migraines. No significant adverse effects were noted. Controlled studies are needed to confirm the findings.

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The supplements appeal to many patients because they have a high degree of safety and are available over the counter at comparatively low cost.

In randomized trials, 60% of patients given megadose riboflavin (200 mg of vitamin B2 twice daily) had a 50% reduction in headache frequency. As is typical in headache studies, 15% of patients who were on placebo had a similar degree of improvement.

Most, but not all, of the small clinical trials to date using magnesium also have shown good results, Dr. Lane said. The dosing is typically 400-600 mg/day of chelated magnesium. The rationale for magnesium therapy stems from interesting work in the last year or two showing that roughly one-third of migraine patients have low brain levels of magnesium during the interictal period between migraine headaches. Low levels are thought to contribute to irritability of the brain's pain generator mechanism, which figures prominently in migraine's pathogenesis, the neurologist explained.

There is no reliable noninvasive method to measure brain magnesium and it is unclear how well blood and brain levels correlate. The normal range for plasma magnesium is 0.6 to 1.0 mmol/L.

Vitamin Supplements May Have Role in Migraine Therapy
Internal Medicine News. Clinical Rounds. April 15, 2000. p41
Bruce Jancin, Denver Bureau

FEVERFEW IN MIGRAINE THERAPY
Feverfew is a promising herbal remedy for reducing the frequency of migraines, Dr. Edzard Ernst reported at an international conference on the efficacy and safety of medicinal herbs. The conclusion was based on a systemic review of clinical trials of feverfew (Chrysanthemum parthenium) in patients with migraine.

Three of five trials showed feverfew to be an effective agent for migraine prophylaxis. However, the analysis did not show that the herb relieves symptoms during a migraine attack.

In one study, treatment with feverfew was associated with a significant 24% reduction in migraine frequency and with significant decrease in nausea and vomiting.

Adverse effects were generally mild and transient: abdominal pain, a bitter taste in the mouth, contact dermatitis, diarrhea, fatigue, gastrointestinal discomfort, inflammation of the lip or tongue, joint pain, loss of taste, ulcerations in the mouth, nausea or vomiting, and tension. Oral symptoms were reduced when the herb was taken in capsule form.

The active ingredient appear to be parthenolides, which inhibit platelet aggregation, inhibit serotonin release, and inhibit prostaglandin synthesis. Because of its antiplatelet effect, it should be avoided by patients taking antiplatelet drugs.

It is contraindicated in children younger than 12, pregnant and lactating women, and people with known hypersensitivity to its constituents, especially the chrysanthemum plant from which the herb is derived.

Feverfew Looks Promising For Reducing Migraine Frequency
Internal Medicine News. Clinical Rounds. April 15,2000 . p41
Batya Swift Yasgur, Contributing Writer