Magnesium Prophylaxis of Menstrual Migraine: Effects on Intracellular Magnesium

Abstract

The effects of oral Magnesium (Mg) pyrrolidone carboxylic acid were evaluated in 20 patients affected by menstrual migraine, in a double-blind, placebo controlled study. After a two cycles run-in period, the treatment (360 mg/day of Mg or placebo) started on the 15th day of the cycle and continued till the next menses, for two months. Oral Mg was then supplemented in an open design for the next two months. At the 2nd month, the Pain Total Index was decreased by both Placebo and Mg, with patients receiving active drug showing the lowest values (P less than 0.03). The number of days with headache was reduced only in the patients on active drug. Mg treatment also improved premenstrual complaints, as demonstrated by the significant reduction of Menstrual Distress Questionnaire (MDQ) scores. The reduction of PTI and MDQ scores was observed also at the 4th month of treatment, when Mg was supplemented in all the patients. Intracellular Mg++ levels in patients with menstrual migraine were reduced compared to controls. During oral Mg treatment, the Mg++ content of Lymphocytes (LC) and Polymorphonucleated cells (PMN) significantly increased, while no changes in plasma or Red Blood Cells were found. An inverse correlation between PTI and Mg++ content in PMN was demonstrated. These data point to magnesium supplementation as a further means for menstrual migraine prophylaxis, and support the possibility that a lower migraine threshold could be related to magnesium deficiency.

A comparative study of magnesium, flunarizine and amitriptyline in the prophylaxis of migraine

“…Ramadan et al reported lower intracellular Mg +2 concentrations in migraine patients versus controls either during or between attacks and suggested that there may be a relation between Mg +2 and the triggering of the migraine attack [18]. Later studies have shown that migraine sufferers have low Mg +2 levels in the serum and/or saliva [36,37], erythrocytes [37][38][39][40], monocytes and lymphocytes [22,40,41]. Mauskop et al reported that 42% of patients have low ionized Mg +2 levels during a migraine attack [17].…”

“…This was also the fact in the study of Taubert where there was no significant difference between magnesium (44%) and placebo (24%) in reducing attack severity [19], though the results were in favor of magnesium. In another study, 300 mg oral magnesium pyrrolidone carboxylic acid reduced both attack frequency and intensity in the patients with menstrual migraine [22].…”

“…This has led to trials questioning the utility of magnesium as a therapeutic choice in the prophylaxis of migraine [19][20][21]22]. In most of these trials oral magnesium therapy has been shown to reduce attack frequency significantly when compared to placebo [19,21,22].…”

“…Studies using magnesium for the prophylactic treatment of migraine have gained interest lately [19][20][21][22], most of them showing a good prophylactic effect of magne-sium versus placebo and a good tolerability of the drug [19,21,22]. Although there have been placebo-controlled trials investigating magnesium in migraine prophylaxis, no study has compared magnesium to other drugs commonly used in migraine prophylaxis.…”

Electromyographical ischemic test, clinical symptoms related to neuromuscular hyperexcitability, and intra- and extracellular Mg++ levels in headache patients

“…Previous research has established the role of magnesium deficiency in migraine, in adults [1][2][3][4][5][6][7], children and adolescents [8,9]. On the other hand, there is recurring evidence, since the early 1960s, that a relative or absolute lack of Mg ++ is related to certain neurological conditions such as criptotetany, latent tetany, hyperventilation syndrome and spasmophilia [10][11][12][13][14][15][16][17].…”