Simvastatin and vitamin D for migraine prevention: A randomized, controlled trial

Abstract

Objective To assess efficacy and tolerability of simvastatin plus vitamin D for migraine prevention in adults with episodic migraine. Methods We performed a randomized, double-blind, placebo-controlled trial with a 12-week baseline period and 24-week intervention period in 57 adults with episodic migraine. Participants were randomly assigned to simvastatin 20 mg tablets twice daily plus vitamin D3 1000 international units capsules twice daily or matching placebo tablets and capsules. Results Compared to placebo, participants using simvastatin plus vitamin D3 demonstrated a greater decrease in number of migraine days from the baseline period to intervention weeks 1-12: a change of -8.0 (IQR: -15.0 to -2.0) days in the active treatment group versus +1.0 (IQR: 1.0 to +6.0) days in the placebo group, P<0.001; and to intervention weeks 13-24: a change of -9.0 (IQR: -13 to -5) days in the active group versus +3.0 (IQR: -1.0 to +5.0) days in the placebo group, P<0.001. In the active treatment group, 8 patients (25%) experienced 50% reduction in the number of migraine days at 12 weeks and 9 (29%) at 24 weeks post randomization. In comparison, only 1 patient (3%) in the placebo group (p=0.03) experienced such reduction. Adverse events were similar in both active treatment and placebo groups. Interpretation The results demonstrate that simvastatin plus vitamin D is effective for prevention of headache in adults with episodic migraine. Given statins ability to repair endothelial dysfunction, this economical approach may also reduce the increased risk for vascular diseases among migraineurs.

Low serum 25-hydroxyvitamin D is associated with higher risk of frequent headache in middle-aged and older men

“…The role of vitamin D in headaches remains unclear, mainly due to predominantly small studies with inconsistent findings89101112131415161718 and the lack of large randomized supplementation trials that would show benefit after improvement of vitamin D status with vitamin D supplementation23. Our study, being one of the largest studies that have investigated the issue, supports the view that vitamin D may be beneficial in headache prevention.…”

“…However, results from larger, randomized, placebo-controlled vitamin D supplementation trials have been mixed1516. Recently, combined therapy with simvastatin and vitamin D 3 reduced the number of days with migraine17. This finding supported the previous cross-sectional observation from the same study group that statin use was associated with lower odds for severe headache or migraine only among those with higher serum 25(OH)D concentrations18.…”

Vitamin D deficiency mimicking chronic tension-type headache in children

“…A few studies have also demonstrated beneficial effects of Vitamin D supplementation (with other drugs) in headache frequency and intensity,7 8 although a few conflicting observations have also been reported in the literature 18. The literature on the relation between vitamin D and tension-type headache is sparse.…”

Hypercoagulability and Migraine

“…Choosing antihypertensive medications which improve endothelial function and prevent migraine, such as lisinopril, candesartan, and verapamil, should be considered. Statins in combination with Vitamin D were demonstrated to prevent migraine in a 2015 study, 101 in addition to their role in controlling lipid levels and decreasing inflammation. Non-pharmacological options that promote endothelial health while preventing migraine include exercise, meditation, and weight loss.…”