Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine—a meta-analysis

Abstract

ObjectiveTo determine the effects of coenzyme Q10 (CoQ10) for reduction in the severity, frequency of migraine attacks and duration of headache in adult patients with migraine.DesignSystematic review and meta-analysis.Data sourcesCochrane Central Register of Controlled Trials, CENTRAL, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO) from inception till December 2019.Study selectionAll randomised control trials comparing CoQ10 with placebo or used as an adjunct treatment included in this meta-analysis. Cross-over designs and controlled clinical trials were excluded.Data synthesisHeterogeneity at face value by comparing populations, settings, interventions and outcomes were measured and statistical heterogeneity was assessed by means of the I2 statistic. The treatment effect for dichotomous outcomes were using risk ratios and risk difference, and for continuous outcomes, mean differences (MDs) or standardised mean difference; both with 95% CIs were used. Subgroup analyses were carried out for dosage of CoQ10 and if CoQ10 combined with another supplementation. Sensitivity analysis was used to investigate the impact risk of bias for sequence generation and allocation concealment of included studies.ResultsSix studies with a total of 371 participants were included in the meta-analysis. There is no statistically significant reduction in severity of migraine headache with CoQ10 supplementation. CoQ10 supplementation reduced the duration of headache attacks compared with the control group (MD: −0.19; 95% CI: −0.27 to −0.11; random effects; I2 statistic=0%; p<0.00001). CoQ10 usage reduced the frequency of migraine headache compared with the control group (MD: −1.52; 95% CI: −2.40 to −0.65; random effects; I2 statistic=0%; p<0.001).ConclusionCoQ10 appears to have beneficial effects in reducing duration and frequency of migraine attack.PROSPERO registration numberCRD42019126127.

Case report: Monoclonal CGRP-antibody treatment in a migraine patient with a mutation in the mitochondrial single-strand binding protein (SSBP1)

“…Topiramate as prophylaxis could cause lactate acidosis and therefore has also to be used with reluctance. Coenzyme Q 10 , magnesium, and riboflavin (vitamin B 2 ) are substances that have shown only minor benefits in reducing headache intensity and headache duration in migraine patients (17)(18)(19)(20). Since all of them are also used in the treatment of mitochondrial disorders (21), a common underlying pathogenic mechanism could be suspected-not only due to similarities in therapeutic approaches but also based on genetic and biochemical evidence (22).…”

Treating Vestibular Migraine When Pregnant and Postpartum: Progress, Challenges and Innovations

“…Coenzyme Q10 supplementation has been successfully used for migraine prophylaxis outside of pregnancy, and included in trials to prevent preeclampsia. 1 , 61 Benefit in vestibular migraine prophylaxis remains unknown.…”

Management of chronic migraine

“…102 103 Magnesium, riboflavin, CoEnzyme Q10, and feverfew have shown efficacy in prevention of migraine in clinical trials and in small systematic reviews, but up-to-date guidelines are still pending. [104][105][106] Recent small studies have examined the role of nontraditional nutraceuticals, such as probiotics, in reducing the burden of migraine, perhaps through anti-inflammatory effects. 107 Butterbur, 108 another herbal supplement, is no longer recommended for prevention of chronic migraine owing to reported cases of liver toxicity.…”