Nutraceuticals and Headache 2024: Riboflavin, Coenzyme Q10, Feverfew, Magnesium, Melatonin, and Butterbur.

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY Current Pain and Headache Reports Pub Date : 2025-01-24 DOI:10.1007/s11916-025-01358-3

Stewart J Tepper, Katharine Tepper

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Abstract

Purpose of review: Nutraceuticals are not regulated by the US Food and Drug Administration, so a careful literature review is essential to make clinical decisions. Riboflavin or vitamin B2 can be recommended for migraine prevention in adults, but pediatric use is not proven. Adverse events are minimal. Coenzyme Q10 has Level C evidence for migraine prevention and low adverse events. Feverfew may be effective for migraine prevention, but the absence of clear safety studies, the differences in doses and characteristics of dried leaf preparations, and the myriad of feverfew cellular effects suggest caution in recommendation for use. Magnesium is recommended for migraine prevention and intravenous acute use, with the potential for generally mild gastrointestinal tolerability adverse events. Melatonin has very low certainty for evidence of efficacy, and is weakly recommended in those with sleep problems. However, purity of US sold melatonin is very poor. Butterbur or petasites preparations have strong evidence for efficacy and concern for hepatotoxicity. Please see the US National Center for Complementary and Integrative Health/NIH online site https://www.nccih.nih.gov/health/butterbur for up-to-date recommendations on whether to use this nutraceutical.

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综述目的：营养保健品不受美国食品和药物管理局的监管，因此仔细查阅文献对临床决策至关重要。可推荐核黄素或维生素 B2 用于成人偏头痛的预防，但儿科用药尚未得到证实。不良反应极少。辅酶Q10在预防偏头痛方面的证据为C级，不良反应较少。热叶草对预防偏头痛可能有效，但由于缺乏明确的安全性研究，干叶制剂的剂量和特性不同，以及热叶草细胞效应的多样性，建议谨慎使用。建议将镁用于偏头痛的预防和急性静脉注射，可能会出现一般较轻的胃肠道耐受性不良事件。褪黑素的疗效证据确定性很低，不建议有睡眠问题的人使用。然而，美国销售的褪黑素纯度很低。牛蒡子或牵牛子制剂的疗效证据确凿，但存在肝毒性问题。有关是否使用这种营养保健品的最新建议，请参阅美国国家补充与整合健康中心/NIH 在线网站 https://www.nccih.nih.gov/health/butterbur。

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来源期刊

Current Pain and Headache Reports CLINICAL NEUROLOGY-

CiteScore

6.10

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings regarding the diagnosis, treatment, and management of pain and headache. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of pain and headache. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anesthetic techniques in pain management, cluster headache, neuropathic pain, and migraine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.