Tier 2 — strong

Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial

P S Sándor, L Di Clemente, G Coppola, U Saenger, A Fumal, D Magis, L Seidel, R M Agosti, J Schoenen
Neurology 2005 64(4):713-715

Bibliography

PubMed
PMID 15728298
DOI
10.1212/01.WNL.0000151975.03598.ED
Funding
Supported by MSE Pharmazeutika GmbH, Bad Homburg, Germany.
Competing interests
The publication states that use of CoQ10 in pain, including migraine, was patent pending in the United States and Europe; Dr. Schoenen had received honoraria from the study sponsor.

Study snapshot

DesignDouble-blind randomized placebo-controlled trial
ModelDouble-blind, randomized, placebo-controlled migraine-prophylaxis trial.
Sample42 patients with migraine randomized to CoQ10 or placebo.
InterventionCoQ10 100 mg three times daily (300 mg/day) versus placebo for a three-month treatment phase after baseline assessment.
Duration3 months
EndpointsMigraine attack frequency; Headache days; Days with nausea; Headache severity; Attack duration; Acute medication use; 50% responder rate; Tolerability

What the study showed, in plain terms

This small double-blind randomized trial compared CoQ10 300 mg/day with placebo in 42 people with migraine. By the third treatment month, CoQ10 outperformed placebo on attack frequency, headache days and days with nausea.

The clearest clinically interpretable result was the 50% responder rate for attack frequency: 47.6% with CoQ10 versus 14.4% with placebo, corresponding to a reported number needed to treat of 3. Attack frequency evolution also favored CoQ10.

Not every migraine dimension improved. The groups did not differ for mean attack duration or acute medication use, and the study was small. It was also industry-supported, with a patent application and sponsor-related honoraria disclosed, which is important context when weighing an otherwise positive efficacy signal.

Key findings

50% responder rate for attack frequency: 47.6% with CoQ10 versus 14.4% with placebo; reported NNT=3.

By the third treatment month, CoQ10 was superior to placebo for attack frequency, headache days and days with nausea.

Attack-frequency change from baseline differed between groups (reported p=0.01), and the longitudinal decrease in attack frequency within the CoQ10 arm was significant (reported p=0.03).

Headache days improved over time in the CoQ10 group; days with nausea also showed a significant between-group evolution. Mean attack duration and acute medication use were not significantly different between groups.

Tolerability: the paper described CoQ10 as well tolerated; no major safety signal was highlighted in the accessible publication record.

What this study can and cannot tell us

Small trial (42 participants), so responder-rate and symptom estimates are imprecise and vulnerable to small-study effects.

Short prophylaxis period of approximately three treatment months; long-term persistence of benefit was not established.

Multiple migraine outcomes were evaluated, and not all were positive.

Industry support, a patent-pending disclosure for CoQ10 use in pain/migraine and sponsor-related honoraria create a meaningful conflict-of-interest context.

Citation network

Articles citing this research paper

6 articles

Biohack Blueprint analyses that reference this study in their evidence base.

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology