Efficacy and Safety of Melatonin as Prophylaxis for Migraine in Adults: A Meta-analysis.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2022-01-01 Epub Date: 2022-11-28 DOI:10.11607/ofph.3211
Haridas Mundot Puliappadamb, Rituparna Maiti, Archana Mishra, Monalisa Jena, Biswa Ranjan Mishra
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Abstract

Aims: To evaluate the efficacy and safety of melatonin for migraine prophylaxis in adults.

Methods: After a comprehensive literature search in the MEDLINE, Cochrane Database, and International Clinical Trial Registry Platform databases, reviewers extracted data from three relevant articles. PRISMA guidelines were followed in the selection, analysis, and reporting of the findings. Quality assessment was performed using the Cochrane risk of bias assessment tool. A random-effects model was used to estimate the effect size, and meta-regression was performed for variables with a likely influence on effect size. Subgroup analysis was performed based on the comparison used in the included studies.

Results: Melatonin therapy in migraine was associated with a significantly higher responder rate when compared to both placebo and standard therapy (OR = 1.84; 95% CI: 1.08 to 3.14; P = .03). The results of the meta-analyses indicated that melatonin can achieve a significant reduction in frequency of migraine attacks (MD = 1.00; 95% CI: 0.02 to 1.98; P = .04), migraine attack duration (MD = 5.02; 95% CI: 0. 91 to 9.13; P = .02), use of analgesics (MD = 1.43; 95% CI: 0.38 to 2.48; P = .008), and migraine severity (MD = 1.93; 95% CI: 1.23 to 2.63; P < .0001) over placebo, but had no significant effects in comparison to amitriptyline or valproate. There was no significant difference in the occurrence of common adverse drug reactions, such as drowsiness and fatigue, between the melatonin group and the comparison groups.

Conclusions: Melatonin showed a beneficial prophylactic role in migraine, with a better responder rate in comparison to placebo in reducing migraine severity, mean attack duration, mean attack frequency, and analgesic use, but did not show significant effects in comparison to amitriptyline or valproate.

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褪黑素预防成人偏头痛的有效性和安全性:一项荟萃分析。
目的:评价褪黑素预防成人偏头痛的疗效和安全性。方法:在MEDLINE、Cochrane数据库和国际临床试验注册平台数据库中进行全面的文献检索后,审稿人从3篇相关文章中提取数据。在选择、分析和报告结果时遵循PRISMA指南。采用Cochrane偏倚风险评估工具进行质量评估。随机效应模型用于估计效应大小,并对可能影响效应大小的变量进行元回归。根据纳入研究中使用的比较进行亚组分析。结果:与安慰剂和标准治疗相比,褪黑素治疗偏头痛的应答率明显更高(OR = 1.84;95% CI: 1.08 ~ 3.14;P = .03)。meta分析结果表明,褪黑素可以显著降低偏头痛发作频率(MD = 1.00;95% CI: 0.02 ~ 1.98;P = .04)、偏头痛发作时间(MD = 5.02;95% ci: 0。91 ~ 9.13;P = 0.02)、镇痛药使用情况(MD = 1.43;95% CI: 0.38 ~ 2.48;P = 0.008),偏头痛严重程度(MD = 1.93;95% CI: 1.23 ~ 2.63;P < 0.0001)优于安慰剂,但与阿米替林或丙戊酸盐相比无显著影响。褪黑素组与对照组在嗜睡、疲劳等常见药物不良反应的发生方面无显著差异。结论:褪黑素在偏头痛中显示出有益的预防作用,在降低偏头痛严重程度、平均发作时间、平均发作频率和止痛药使用方面,与安慰剂相比,褪黑素的反应率更好,但与阿米替林或丙戊酸盐相比,褪黑素没有显示出显著的效果。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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