2004-06-01
Jane E. Allen, The Los Angeles Times

For years, Joan Rozen lived on Excedrin pills, too busy as a mother and teacher to bow to daily migraine headaches.

"Sometimes they would get so intense I would get nauseated, but I just had to keep going," said Rozen, 60, of Binghamton, N.Y.

A couple of years ago her son Todd, a neurologist, suggested that coenzyme Q10, a dietary supplement he'd studied for migraine prevention, might break her dependence on the aspirin-based pills. She began taking 150 milligrams daily and was told the medication could take a few months to work.

Then, one day, "I realized I wasn't getting these daily headaches," Rozen said. "I cannot tell you what a tremendous difference it has made in my life."

Coenzyme Q10 is among dietary supplements showing promise in preventing or reducing the severity of migraines suffered by an estimated 28 million Americans.

Often preceded by flashing lights or other visual disturbances, the potentially disabling headaches are often unstoppable, sending sufferers retreating into quiet, dark rooms. Powerful drugs called triptans have proven effective at aborting migraines, but patients want a way to avert the attacks.

Daily doses of some prescription blood pressure drugs, antidepressants and anti-seizure drugs can be taken as preventives, but have significant side effects and don't help everyone.

As a result, a growing number of patients, heartened by emerging research, are embracing prevention using relatively inexpensive over-the-counter dietary supplements, which have few side effects.

"The bottom line is that there are safe alternatives with a firm scientific basis for preventing migraine for people who don't want to take prescription drugs, that also can be used to complement prescription drugs," said Dr. Richard B. Lipton, a neurology professor at Albert Einstein College of Medicine in the Bronx, N.Y.

They include:

Coenzyme Q10: Dr. Todd Rozen, a headache specialist at the Michigan Head Pain & Neurological Institute in Ann Arbor, conducted early research demonstrating CoQ10's potential to prevent migraines. Because some migraines have been associated with a deficiency in cells' ability to generate energy, Rozen thought it made sense to test a compound important to the functioning of cells' batteries, the mitochondria. Swiss researchers reported April 28 at the American Academy of Neurology's annual meeting that 300 milligrams daily halved the incidence of migraines, compared with dummy pills.

"I certainly wouldn't hesitate to put patients on it," said Dr. Robert B. Daroff, a neurology professor at Case Western Reserve University School of Medicine in Cleveland, and current president of the American Headache Society.

Magnesium: Several studies have shown that magnesium prevents migraines in about half of cases. Dr. Alexander Mauskop, director of the New York Headache Center, who has long studied magnesium, believes about 50 percent of migraine patients have an underlying magnesium deficiency. Recommended doses range from 360 milligrams to 1 gram. Magnesium can cause diarrhea if taken on an empty stomach and should be taken with nondairy meals because it interferes with calcium absorption. It shouldn't be used by people with serious kidney problems.

Riboflavin: Also called vitamin B-2, it's been shown in several studies to work better than a placebo in the prevention of migraines. The usual dose is 400 milligrams. Riboflavin acts on energy production within mitochondria.

Feverfew: This herbal relative of the daisy may prevent some of the blood vessel dilation associated with migraine pain. One major caution: Feverfew can interact with Coumadin and other blood thinners.

Magnesium-riboflavin-feverfew combinations: Sold under the brand names MigreLief and MigraHealth, two pills pack 300 milligrams of magnesium, 400 milligrams of riboflavin and 100 milligrams of feverfew.

Butterbur root extract: Sold under the brand name Petadolex, the soft gel tablets have been shown in several studies, including one published in the February issue of the journal European Neurology, to halve migraine frequency.