Magnesium oxide, riboflavin may reduce episodic migraine during pregnancy

The use of magnesium oxide either alone or in combination with riboflavin may help prevent episodic migraines during pregnancy, according to a study presented at SMFM 2022.

“Our institution has used magnesium oxide for migraine prophylaxis in our obstetric patients since 2005, yet there have been no published studies on its efficacy. When magnesium oxide fails, riboflavin is often added as second-line [therapy],” said the researchers.

Using data from the Los Angeles County and University of Southern California Medical Center between 2015 and 2020, the researchers conducted a retrospective cohort study involving 203 women (median age 30 years, median gestational age 16 weeks and 2 days) diagnosed with migraine during pregnancy and were treated with magnesium oxide 400 mg. Majority of the patients took it twice daily. [SMFM 2021, abstract 1086]

Patients treated with magnesium oxide demonstrated a reduction in migraine days per month (from a median of 16 days to 1 day), migraine duration (from 12 to 0 hours), and migraine severity (from 8 to 2 out of 10 scale in pain severity).

Fewer patients on magnesium oxide also experienced migraine-related symptoms after treatment than before treatment (17.0 percent vs 75.0 percent).

Overall, 59.0 percent of the patients achieved successful treatment outcomes with magnesium oxide, as shown by improvements in the frequency, severity, and duration of migraine attacks. Only three patients experienced mild gastrointestinal side effects, which did not lead to treatment discontinuation.

Moreover, among those requiring additional treatment, 94.0 percent of the patients were successfully treated with the combination therapy of magnesium oxide and riboflavin.

In another study, an increased risk of maternal and foetal adverse outcomes was observed among pregnant women with migraine. [SMFM 2022, abstract 144] Therefore, it is important to choose appropriate therapy in preventing the onset of migraine in this population.

“[Treatment with] magnesium oxide for [the] prevention of episodic migraines during pregnancy is a safe and effective method, … with few side effects,” said the researchers.

When further medical management is needed, the addition of riboflavin to magnesium oxide also successfully controls migraine attacks in pregnant women, the researchers noted.