Prophylaxis of migraine headaches with riboflavin: A systematic review

Abstract

SummaryWhat is known and objective: Migraine headache is a relatively common, debilitating condition that costs our healthcare system over 78 billion dollars per year. Riboflavin has been advocated as a safe, effective prophylactic therapy for the prevention of migraines. The purpose of this study was to provide a systematic review of the current role of riboflavin in the prophylaxis of migraine headache. Methods What is new and conclusion:Riboflavin is well tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient's migraine headache frequency.Additional data are needed, however, to resolve questions involving pharmacokinetic issues and pharmacogenomic implications of therapy. K E Y W O R D Smigraine, pharmacogenomics, pharmacokinetics, riboflavin | WHAT IS KNOWN AND OBJECTIVEMigraine headache is a common, often disabling neurologic condition characterized by painful headaches associated with nausea, vomiting, and hypersensitivity to visual, auditory, and olfactory stimuli. The worldwide prevalence of migraine headache is about 10%; however, it is slightly higher in the United States at 12%.1,2 Women experience migraine headache at a greater rate (15%-17%) as compared to men. 1,3Epidemiologic data suggest that while 38% of patients with migraine headache need prophylactic therapy, only 3%-13% currently take prophylactic treatment. 4 Prophylactic therapy should be considered in situations where the patient feels that the recurring migraine headaches interfere with their daily routines and responsibilities despite acute treatment. 1-4The goals of treatment for patients requiring prophylactic therapy are to decrease the frequency, duration and severity of attacks,

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“…Concerning riboflavin therapy in migraine patients, a recent systematic review has tackled this issue (100). Riboflavin role in migraine therapy is prophylactic, in other words, it affects migraine attacks frequency, severity, duration, and related disability, and facilitates acute therapies of migraine attacks (100).…”

“…Riboflavin role in migraine therapy is prophylactic, in other words, it affects migraine attacks frequency, severity, duration, and related disability, and facilitates acute therapies of migraine attacks (100). According to the American Academy of Neurology, riboflavin is considered a level B therapy in migraine prophylaxis (100). Riboflavin, as a migraine prophylactic agent, has been studied in adults and children.…”

“…Riboflavin, as a migraine prophylactic agent, has been studied in adults and children. Five clinical trials involving adult patients have been evaluated in a systematic review with positive results (100). Indeed, a significant reduction in migraine attack frequency, 59% reduction, has been noted in a randomized double-blind placebo-controlled trial using 400 mg/day of riboflavin (100).…”

“…Five clinical trials involving adult patients have been evaluated in a systematic review with positive results (100). Indeed, a significant reduction in migraine attack frequency, 59% reduction, has been noted in a randomized double-blind placebo-controlled trial using 400 mg/day of riboflavin (100). Also, two open-label trials using 400 mg/day of riboflavin have decreased migraine attack frequency from 4 attacks per month to 2 attacks per month, and from 8.7 attacks per month to 2.9 attacks per month, respectively (100).…”

“…Indeed, a significant reduction in migraine attack frequency, 59% reduction, has been noted in a randomized double-blind placebo-controlled trial using 400 mg/day of riboflavin (100). Also, two open-label trials using 400 mg/day of riboflavin have decreased migraine attack frequency from 4 attacks per month to 2 attacks per month, and from 8.7 attacks per month to 2.9 attacks per month, respectively (100). In addition, as migraine prophylactic agents, 400 mg/day of riboflavin was comparable with 500 mg/day of sodium valproate and 100 mg/day of riboflavin was comparable with 80 mg/day of propranolol, with no statistical differences between groups in their prophylactic actions, with a more favorable side effect profile in the riboflavin groups (100).…”