April 29, 2004 (San Francisco) — The antioxidant CoQ10, or ubiquinone, wards off migraine attacks in patients, according to research presented here at the American Academy of Neurology annual meeting.
"Coenzyme Q10 proved to have a significant effect in reducing migraine propensity and had an extremely favorable side-effect profile," lead author Peter S. Sandor, MD, research fellow in the neurology department at University Hospitals in Zurich, Switzerland, said during a presentation.
Dr. Sandor theorized that migraine may be caused by a decrease in mitochondrial energy reserve, and that CoQ10 serves as an energy boost in the brain. The substance was found useful in a previous open-label study in 2002, he said.
The researchers conducted a double-blind, placebo-controlled study of 42 people who suffered an average of 4.4 migraine attacks per month, with or without aura. No other form of migraine prophylaxis was allowed during the study.
After a month of a baseline placebo, patients randomly assigned to the treatment group received 100 mg of CoQ10 three times a day, while the remaining patients continued to receive placebo. A liquid, water-soluble form of CoQ10 was used for better diffusion into the cells, Dr. Sandor said.
Approximately 48% of those who took CoQ10 had a 50% response rate during the three-month study, while this occurred in about 14% of those taking a placebo. "That is a 33% therapeutic gain," Dr. Sandor said. "You would need to treat three patients to have one successful."
The number of migraine attacks per month was reduced in the treatment group from 4.4 to 3.2, with no change in the placebo group.
In addition, participants receiving CoQ10 also had fewer days with a headache and fewer days with nausea.
Adverse effects were minimal, although one patient developed an allergic skin rash and withdrew from the study. However, these effects are mild compared with those of other medications to prevent migraine such as beta blockers, Dr. Sandor pointed out. "This is an extremely important point," he said, "How often do we treat young females? We do not want to give substances which may be teratogenic."
The study was well conducted and had a solid methodology, noted David Dodick, MD, an associate professor of neurology at the Mayo Clinic in Scottsdale, Arizona, who moderated the session.
"It seemed to have a robust, statistically significant effect over placebo," he told Medscape.
If the findings can be replicated in a larger clinical trial, CoQ10 may provide an alternative to migraine sufferers who do not like taking prescription medications and would prefer a natural alternative, Dr. Dodick said.
However, the researchers used a liquid formulation not equivalent to what is currently available in the U.S. "The data is not generalizable to what a patient would buy in a pharmacy," Dr. Dodick noted. "You can't just buy the tablets and get an effect."
The study was funded by MSE.
AAN 56th Annual Meeting: Abstract S43.004. Presented April 28, 2004.
Reviewed by Gary D. Vogin, MD
Melissa Schorr is a freelance writer for Medscape.
Medscape Medical News © 2004 Medscape
Cite this: Coenzyme Q10 May Ward Off Migraine Attacks - Medscape - Apr 29, 2004.