Research: MAIZELS and colleagues,

Listed in Issue 111


MAIZELS and colleagues, Kaiser Permanente, Family Practice, Woodland Hills, CA, USA, have tested a combination of riboflavin, magnesium, and feverfew in the prevention of migraine.


Previous studies of magnesium and feverfew for migraine prophylaxis have yielded conflicting results, and there has been only a single placebo-controlled trial of riboflavin. The aim of this study was to determine the efficacy for migraine prophylaxis of a preparation of riboflavin, magnesium, and feverfew.


In this randomized double-blinded placebo-controlled trial, 120 patients were randomized to receive either a compound providing a daily dose of 400 mg riboflavin, 300 mg magnesium, and 100 mg feverfew, or a placebo containing 25 mg riboflavin. The study included a 1-month run-in phase and 3-month trial.


49 patients completed the 3-month trial. For the primary outcome measure, a 50% or greater reduction in migraines, there was no difference between active and 'placebo' groups. Similarly, there was no significant difference in secondary outcome measures for active versus placebo groups: 50% or greater reduction in migraine days, or change in mean number of migraines, migraine days, migraine index, or triptan doses. Compared to baseline, however, both groups showed a significant reduction in number of migraines, migraine days, and migraine index. This effect exceeds that reported for placebo agents in previous migraine trials.


25 mg riboflavin showed an effect comparable to a combination of 400 mg riboflavin, 300 mg magnesium, and 100 mg feverfew. The placebo response exceeds that reported for any other placebo in trials of migraine prophylaxis, and suggests that 25 mg riboflavin may be an active migraine-preventing medicine.


Maizels M, Blumenfeld A, Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial. Headache 44 (9): 885-890, Oct 2004.

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