Vitamins and herbal supplements for migraine prevention (6)
| Compound | Daily dose | Canadian Headache Society | |
|---|---|---|---|
| Level of evidence* | Strength of recommendation† | ||
| Magnesium citrate | 600 mg (300 mg twice daily) | Low | Strong |
| Riboflavin | 400 mg (200 mg twice daily) | Low | Strong |
| Coenzyme Q10 | 300 mg (100 mg 3 times daily) | Low | Strong |
| Butterbur‡ | 150 mg (75 mg twice daily) | Moderate | Strong |
Note: GRADE = Grading of Recommendations, Assessment, Development and Evaluation. Adapted with permission from Pringsheim T, Davenport WJ, Mackie G, et al.; Canadian Headache Society Prophylactic Guidelines Development Group. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci 2012;39(Suppl 2):S1–59.
↵* Levels of evidence using the GRADE system: high = the guideline authors are confident that the true effect lies close to the estimate given by the evidence available; moderate = the guideline authors are moderately confident in the effect estimate, but there is a possibility it is substantially different; low = the confidence in the effect estimate is limited. The true effect may be substantially different; very low = the guideline authors have little confidence in the effect estimate.
↵† Recommendation categories using the GRADE system: strong = benefits clearly outweigh the risks for most patients; weak = the balance between benefits and risks is narrow and there is uncertainty about when it should be used.
↵‡ Only commercially prepared products in which plant carcinogens and hepatotoxic alkaloids have been removed and that have been standardized to contain a minimum of 15% petasins are recommended. Patients should be cautioned against consuming the plant in any other form.