Melatonin for Migraine?

Alan R. Jacobs, MD


May 21, 2013

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This is the Medscape Neurology Minute. I am Dr. Alan Jacobs. At the American Academy of Neurology 65th Annual Meeting, sleep researchers from the São Paulo Headache Center presented results from a multicenter, randomized, double-blind, placebo-controlled trial assessing the ability of melatonin to prevent migraine headaches. A total of 178 men and women met the International Headache Society diagnostic criteria for migraine with and without aura and had 2-8 migraine attacks per month. Participants were randomly assigned to 3 mg of melatonin, 25 mg of amitriptyline, or placebo for 3 months. Medications were taken between 10:00 PM and 11:00 PM daily. The primary outcome was the reduction in the number of headaches per month. Secondary endpoints included migraine intensity and duration and analgesic use. Tolerability was also measured in all 3 study groups. The mean reduction in headache frequency was 2.7 in the melatonin group, 2.18 in the amitriptyline group, and 1.18 in the placebo group. The proportion of responders was greatest in the melatonin group at 54% vs 39% for amitriptyline and 20% for placebo. Melatonin was very tolerable and associated with fewer adverse effects compared with amitriptyline. Patients gained weight in both the amitriptyline and placebo groups, but melatonin was associated with weight loss. The researchers rated the study's findings as promising and warranting further research. This has been the Medscape Neurology Minute. I'm Dr. Alan Jacobs.