Alternative Therapies for Chronic Headache Recommended as Treatment Option

BY MAURY M. BREECHER
Contributing Writer

ORLANDO - (ECCC) Primary care providers who treat chronic migraines should consider using alternative therapies because there is good research that shows they work, said Dr. Alexander Mauskop on July 21 during a symposium co-sponsored by the Diamond Headache Clinic Research and Education Foundation.

"I use all the standard drugs already mentioned during this conference, but I always begin my treatment with alternative therapies," said Dr. Mauskop, the director of the New York Headache Center.

Dr. Mauskop focused his presentation on several such therapies, including acupuncture, treatment with supplemental magnesium, and botanical remedies such as Petasites hybridus-butterbur (Petadolex®).

He said that the majority of 14 randomized controlled clinical trials that compared true acupuncture with sham acupuncture showed "a trend in favor of true acupuncture" (Cephalalgia 1999;19:779-80).

Magnesium has also proven to be a useful alternative treatment, according to Dr. Mauskop. He reported that researchers have found that people with migraines have lower levels of magnesium in their brains (Headache 1989;29:590-3 and Headache 2002;42:114-9).

He went on to cite several studies that have shown magnesium can prevent migraine attacks. One was a prospective placebo-controlled study of 81 migraine patients aged 18-65 years who received either orally 600 mg of magnesium (trimagnesium dicitrate) daily for 12 weeks or a placebo. The results revealed that in 9-12 weeks, the migraine attack frequency was reduced by 41.6% in the magnesium group and by only 15.8% in the placebo. The number of days with migraine and the drug consumption for symptomatic treatment per patient also decreased significantly in the magnesium group (Cephalalgia 1996;16:257-63).

Dr. Mauskop also cited studies that indicate the effectiveness of Riboflavin, a-lipoic acid, Coenzyme Q10, and Petasites hybridus-butterbur-each as preventive treatments for migraine. The studies revealed that these substances reduced headache attack frequency and, in some instances, improved headache disability.

He added that although Petasites hybridus-butterbur is a common weed, patients should be warned against using home-brewed concoctions of the substance because it is carcinogenic. He said that a purified pharmaceutical grade of Petasites hybridus-butterbur can be used safely (specifically Petadolex®). Other alternative therapy studies cited include:

• Riboflavin (Neurology 1998;50:436-40)
• a-lipoic acid (Headache 2007;47:52-7)
• Coenzyme Q10 (Neurology 2005;64:713-5)
• Petasites hybridus-butterbur (Neurology 2004;63:2240-4)

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