Written by Greg Arnold, CSCS. Sixty migraine sufferers, who took 3 milligrams of melatonin for 12 weeks, significantly improved the frequency, intensity and duration of their migraines compared to the 59 participants in the placebo group.
Migraine headaches are a dysfunction of the nerves and blood vessels in the brain. They are characterized by nausea and vomiting, pain with exposure to light (photophobia) and sound (phonophobia) and severe recurrent headache 1. The International Headache Society has divided migraines into two types: migraine without aura (75% of sufferers) and migraine with aura (25% of sufferers) 1. Aura refers to subjective sensations such as voices or lights before episodes. Migraine headaches affect 12% of Americans and cost our healthcare system $24 billion each year 2.
Prescription medications are used in an attempt to treat migraines 3 but their side effects 4 make those suffering from migraines among the most dissatisfied patients 5. As a result, finding alternatives to prescription medications for migraines is at a premium.
Now a new study 6 suggests that melatonin may be an option. The study involved 118 subjects (22 men, 96 women) between the ages of 24 and 40. They were assigned to receive either melatonin (3 milligrams/day = 60 subjects), the prescription medication amitriptyline (25 mg/day = 59 subjects) or placebo (59 subjects) for 12 weeks. Patients self-reported their headache symptoms throughout the 12 weeks.
After 12 weeks, the researchers noted the following headache symptoms in the melatonin and amitriptyline group compared to the placebo group:
| Placebo | Amitriptyline | Melatonin | p-value | |
|---|---|---|---|---|
| Migraine frequency (days per week) | 6.2 | 5 (19.4% less than placebo) | 4.6 (25.9% less than placebo) | < 0.05 |
| Migraine intensity (0-10) | 4.8 | 3.5 (28.1% less than placebo) | 3.6 (25% less than placebo) | < 0.05 |
| Average migraine duration (hours) | 16.2 | 9.8 (39.6% less than placebo) | 10.9 (32.8% less than migraine) | < 0.05 |
Regarding side effects, melatonin was “tolerated better than amitriptyline”. Specifically, 20% of those in the melatonin group had sleepiness compared to 40.6% in the amitriptyline group, 3% had chest pain (“epigastralgia”) compared to 8.5% in the amitriptyline group. Other side effects in the amitryptline included dry mouth (35.5%), fatigue (24.3%), somnolence (17.8%), weight increase (13.6%) and dizziness (10.7%).
A final significant benefit for the melatonin group was the average of 0.3-lb. weight loss compared to 2.13-lb. weight gain the amitriptyline group and 0.946-lb. weight gain in the placebo group (p = < 0.01). The researchers stated “This is a very important and original finding that deserves special discussion. There is substantial experimental evidence in the literature indicating the role of melatonin in the control of food intake, energy balance and body weight” 7,8.
For the researchers, “Melatonin 3 mg is better than placebo for migraine prevention, more tolerable than amitriptyline and as effective as amitriptyline 25 mg” and “Different melatonin doses (lower and higher) should be studied, as well as its effect in other migraine types and comorbidities.”
Source: Gonçalves, Andre Leite, Adriana Martini Ferreira, Reinaldo Teixeira Ribeiro, Eliova Zukerman, José Cipolla-Neto, and Mario Fernando Prieto Peres. “Randomised clinical trial comparing melatonin 3 mg, amitriptyline 25 mg and placebo for migraine prevention.” J Neurol Neurosurg Psychiatry 87, no. 10 (2016): 1127-1132.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) http://creativecommons.org/licenses/by-nc/4.0
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Posted August 22, 2016.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.
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- Olesen J. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9-160.
- Healthcare T. New Data Estimate Migraine Headaches Cost U.S. Employers more than $24 Billion Annually.
- Loder E, Burch R, Rizzoli P. The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. Headache. 2012;52(6):930-945.
- Davies GM, Santanello N, Lipton R. Determinants of patient satisfaction with migraine therapy. Cephalalgia. 2000;20(6):554-560.
- Lipton RB, Stewart WF, Simon D. Medical consultation for migraine: results from the American Migraine Study. Headache. 1998;38(2):87-96.
- Goncalves AL, Martini Ferreira A, Ribeiro RT, Zukerman E, Cipolla-Neto J, Peres MF. Randomised clinical trial comparing melatonin 3 mg, amitriptyline 25 mg and placebo for migraine prevention. J Neurol Neurosurg Psychiatry. 2016;87(10):1127-1132.
- Alonso-Vale MI, Peres SB, Vernochet C, Farmer SR, Lima FB. Adipocyte differentiation is inhibited by melatonin through the regulation of C/EBPbeta transcriptional activity. J Pineal Res. 2009;47(3):221-227.
- Nduhirabandi F, Du Toit EF, Blackhurst D, Marais D, Lochner A. Chronic melatonin consumption prevents obesity-related metabolic abnormalities and protects the heart against myocardial ischemia and reperfusion injury in a prediabetic model of diet-induced obesity. J Pineal Res. 2011;50(2):171-182.
