Riboflavin may be an effective therapy for the prevention of migraine
headaches in some adults, according to a new review published in the Journal of Clinical Pharmacy and Therapeutics.
To better understand the safety and effectiveness of riboflavin, an
extensive literature search was conducted for relevant studies that
included trials of riboflavin in the prophylactic treatment of migraine
headache. Eleven clinical trials were used for the basis of this review
which provided mixed results on therapeutic effect.
One study, which included 55 adult patients, compared riboflavin
400mg/day to placebo for 3 months. Results showed a significant
difference in attack frequency (P<0 .0001="" and="" attack="" days="" i="" number="" of="">P
A Class II study, comparing riboflavin 400mg/day to sodium valproate
500mg/day found that both treatments reduced headache severity,
frequency and duration (reduction in number of headaches/month:
riboflavin: 9.2±6.2 to 2.4±1.6; sodium valproate: 6.5±3.1 to 2.1±1.0),
demonstrating non-inferiority of riboflavin to sodium valproate. In
addition, the riboflavin arm experienced less adverse effects (P=0.005).
Other lower Class studies found that riboflavin was associated with a
decrease in migraine frequency (Boehnke et al. 2004; Shoenen et al.
1994; Nambiar et al. 2011).
Evidence was weaker in studies that assessed riboflavin in children
with migraines. A double-blind, placebo-controlled trial (MacLennon et
al. 2008) of 48 migraine patients aged 5 to 15 found that 66.6% of the
placebo group, and 44.4% of the riboflavin 200mg/day group, had a
reduction of 50% in migraine frequency. Another trial, this time
involving 42 children 6–13 years old, found that a reduction in mean
frequency was not statistically significant for riboflavin compared to
placebo (3.60 migraines/month to 2.05 migraines/month for riboflavin vs.
3.05 migraines/month to 1.4 migraines/month for placebo).
Moreover, there are still questions about what constitutes a
therapeutic dose as limited information suggests that only a maximum of
27mg of riboflavin can be absorbed from a single dose. However, in
clinical trials, doses ranged from 50–400mg, substantially higher than
the amount found in vitamin supplements. More studies are needed to
determine whether higher doses actually impart greater benefits.
The authors concluded that for adult prophylaxis, riboflavin "is well
tolerated, inexpensive and most controlled clinical trials have shown
modest reductions in migraine headache frequency." In children and
adolescents, however, the results are still inconclusive.
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