A new water-soluble form of coenzyme Q10 was found to be effective for migraine prophylaxis in a small, double-blind, randomized, placebo-controlled study. The results supported the findings of a positive open-label trial of coenzyme Q10 for migraine prophylaxis conducted in 2002 by researchers at the Jefferson Headache Center of Thomas Jefferson University in Philadelphia, noted Peter S. Sandor, MD, of the Department of Neurology at University Hospital, Zurich.
Dr. Sandor said his research on the potential migraine-preventive qualities of coenzyme Q10 were motivated in part by favorable results for another coenzyme in mitochondrial metabolism -- high-dose riboflavin -- for migraine prophylaxis. Dr. Sandor and his colleagues used coenzyme Q10 at 100 mg. three times daily for migraine prophylaxis -- twice as much as the dosage used in the open trial. After a one-month placebo baseline, 21 migraineurs were randomized to placebo and 21 were randomized to coenzyme Q10 for three months, Dr. Sandor reported. The results of the study were presented at the 11th Congress of the International Headache Society.
The researchers found significant improvement in attack frequency, headache days, and days without nausea but no difference in severity and duration between the two groups. In the coenzyme Q10 group, 47.6% of the patients had a 50% reduction in attack frequency from baseline compared to 14.3% for the placebo group, resulting in a therapeutic gain of about 33.3%, Dr. sandor reported. Coenzyme Q10 was well tolerated in general, although one person developed a cutaneous allergy and withdrew from the trial, he said.
In the open-label trial, Dr. Sandor noted, no adverse events were associated with coenzyme Q10 therapy in any of the patients, and the researchers reported that 61.3% of the patients treated had a greater than 50% reduction in number of days with migraine headache. While the authors of that paper suggested that “dosages above 150 mg may yield even higher 50% reduction rates than was demonstrated in the open-label study”, Dr. Sandor remarked that when he and his colleagues doubled the dose of coenzyme Q10, the 50% reduction rate was, in fact, lower than that found in the open trial. Larger randomized controlled trials and dose-finding trials are needed to better determine the most efficacious dose of coenzyme Q10 for migraine prophylaxis, he said.