Magnesium in migraine prophylaxis-Is there an evidence-based rationale? A systematic review

Magnesium is the second most abundant intracellular cation functions as a cofactor in over 325 different intracellular reactions. A clinical trial showed a significant use of 1000mg of magnesium sulfate in migraineurs. Many more studies also conducted that proved the magnesium deficiency as the major factor in the pathogenesis of migraine. Therefore, this review provides grade C evidence for prevention of migraine with magnesium.

The principal objective of the analysis was to evaluate the present evidence base on magnesium in migraine prophylaxis systematically.

Using standard search terms and MeSh terms on PubMed and EMBASE, clinical trials were searched involving trials which assessed the protective magnesium effect among migraineurs of age 18-65 from 1990 to 2016. The trials were identified and sorted as per the International Headache Society guidelines for controlled trials and predefined eligibility criteria. FR and AvL jointly analyzed the results by applying the evidence classification scheme given by the American Academy of Neurology and the Cochrane bias tool to evaluate the evidence bias. Primary endpoints were the number of migraine attacks and the number of migraine days as per the guidelines. The current review was not authorized.

A total of five trials accomplished the selection procedure. A notable decline of the number of migraine attacks was shown by one out of two Class I evidence trials than placebo. However, A statistically significant reduction of the primary efficacy parameters as compared to placebo was seen two out of three Class III trials.

Grade C evidence was provided by this systematic review for the migraine prevention with magnesium. The high levels of magnesium dicitrate (600 mg) appear to be a safe and cost-effective approach clinically.