Non-pharmacological approach to migraine prophylaxis: part II

Acupuncture has been used to both prevent and treat diseases for over 3,000 years. Recently, a Cochrane review on its use in migraine concluded that acupuncture is effective and should be considered as a prophylactic measure for patients with frequent or insufficiently controlled migraine attacks. In contrast, there is no clear evidence to support or refute the use of homeopathy in the management of migraine. Among vitamins and other supplements, riboflavin and coenzyme Q10 significantly decreased the frequency of migraine attacks. Alpha lipoic acid also reduced migraine frequency, albeit not significantly as compared to placebo. The prophylactic efficacy of magnesium, particularly for children and menstrually related migraine, has recently been substantiated. Among the herbal remedies, butterbur significantly decreases attack frequency, whereas the efficacy of feverfew was not confirmed in a Cochrane review, probably because of the 400% variations in the dosage of its active principle. Finally, ginkgolide B has proved significantly effective in controlling migraine with aura and pediatric migraine in uncontrolled studies that need a confirmation.