Melatonin as a Natural Migraine Preventative
Overview of Melatonin and Migraines
Melatonin is recognized as a natural remedy with a favorable side effect profile that may help prevent migraines. A recent study has compared the efficacy and safety of melatonin with the widely prescribed preventative medication amitriptyline.
Understanding Migraines
Migraine headaches are prevalent and are characterized by recurring moderate to severe headache episodes, autonomic nervous system dysfunction such as vomiting, and neurological symptoms like visual disturbances in some individuals. Preventative medications for migraines include beta-blockers, tricyclic antidepressants, serotonin receptor antagonists, valproic acid, topiramate, and gabapentin. Despite the availability of these medications, only three to five percent of migraine sufferers receive preventative treatment, primarily due to the unfavorable side effects associated with these drugs.
The Importance of Side Effect Profiles
For individuals with migraines, daily preventative therapy is essential to reduce the frequency of attacks. Therefore, the side effect profile of any medication is a crucial consideration. There is a strong demand for effective and tolerable treatment options.
The Study on Melatonin vs. Amitriptyline
Researchers from the Albert Einstein Hospital’s Department of Neurology in Sao Paulo, Brazil, conducted a study to evaluate melatonin against amitriptyline, a commonly used preventative therapy. Participants were randomly assigned to receive melatonin, amitriptyline, or a placebo, and were monitored over 12 weeks. The primary endpoint was the number of migraine headache days per month. Secondary outcomes included headache severity reduction, duration of headache attacks, pain reliever usage, and the percentage of patients who experienced a greater than 50% reduction in migraine headache days.
Study Findings
The results of this study were reported by the Canadian Pharmacists Association in a headache report. Both melatonin (3 mg) and amitriptyline (25 mg) demonstrated superior efficacy compared to placebo in reducing the number of migraine headache days. Notably, melatonin outperformed amitriptyline in achieving a reduction of at least 50% in headache frequency, although further studies are necessary to validate these findings and to explore other dosages (5 mg, 10 mg) and formulations (such as fast dissolving or spray).
Side Effects and Long-Term Considerations
Throughout the 12-week study, participants did not report any serious side effects. The most commonly noted side effect for both melatonin and amitriptyline was drowsiness. While these medications are typically taken at bedtime, morning sleepiness was frequently reported, with the amitriptyline group experiencing higher levels of drowsiness. Given that migraine sufferers may require long-term preventative therapy, additional studies are needed to assess the safety and efficacy of melatonin over extended durations, ideally at least one year.
Conclusion: Melatonin as a Viable Option
Melatonin emerges as a safe and natural option for migraine prevention. It is available over the counter at a low cost, potentially enhancing the quality of life for individuals suffering from migraines.
References
(1) Worthington, I. Headache. Canadian Pharmacists Association RXTX. 2017.
(2) Gonçalves AL, Martini Ferreira A, Ribeiro RT et al. Randomised clinical trial comparing melatonin 3 mg, amitriptyline 25 mg and placebo for migraine prevention. J Neurol Neurosurg Psychiatry. 2016.