Prophylactic magnesium administration is a potentially effective option for the prevention of migraine, according to findings from a systematic analysis published in Headache.
Researchers searched the PubMed and EMBASE databases for double-blind, randomized, placebo-controlled clinical trials investigating the prophylactic effect of magnesium on migraine prevention in adult patients. For evaluating the effect of magnesium administration, the investigators chose the reduction in the number of migraine attacks as well as the reduction in the number of migraine days as the primary efficacy parameters.
A total of 5 clinical trials meeting these requirements were found and included in the final analysis (N=253). The included trials looked at magnesium administration among those with menstrual migraine, migraine with and without aura, and standard migraine symptoms. Among these 5 trials, 1 study demonstrated that magnesium was associated with a significant 43% reduction in the number of migraine days compared with baseline (from 4.7±3.1 to 2.4±2.2 at the second month; P <.01).
Another study with class I evidence found that administration of magnesium vs placebo was also associated with a significant reduction in the number of migraine days (P <.03). The number of migraine days and the number of migraine attacks were also reduced in another class III trial included in this review. Overall, the investigators found grade C evidence for the use of magnesium for migraine prophylaxis, indicating its possible effectiveness for the migraine population.
On the basis of these findings, the investigators suggest “prophylactic treatment with a high dose of trimagnesium dicitrate (600 mg daily)” in patients with migraine is a safe, tolerable, and cost-effective approach for clinical practice.
von Luckner A, Riederer F. Magnesium in migraine prophylaxis-is there an evidence-based rationale? A systematic review [published online November 13, 2017]. Headache. doi: 10.1111/head.13217