Melatonin and Migraine Headaches

For any person who suffers from migraine headaches, there is little they won’t try to attempt to assuage the pain and disruption to life caused by these monster headaches. There are numerous pharmacological treatments on the market today, covering a wide range of medication class, including prophylactic medications such as beta blockers, serotonin antagonists, SSRIs, NSAIDs, tricyclic antidepressants and even anticonvulsants, and abortive medications like analgesics, butalbital compounds, sedatives, steroids, and opiods.

Unfortunately, none of these pharmacological interventions work consistently for migraine sufferers, whose headaches manifest themselves in varying degrees of pain control resistance and intractability. More problematic for many is the fact that most of these treatments are accompanied by myriad side effects, some of which are intolerable to the patient, or at the very least, a disappointing trade off.

Recently, some reports have been published regarding the efficacy of Melatonin as a prophylactic treatment for migraine headaches.

Melatonin is a hormone that is produced by the pineal gland of the brain, and is responsible for the regulation of the body’s sleep cycle. Naturally, the body produces more melatonin in the evening, after dark, and wanes in production after the sun comes up. Because of the connection between melatonin and sleep, manufactured melatonin has been used in the past to treat jet lag, seasonal affective disorder, and sleeping disturbances.

So, what is the hope for the correlation between melatonin and migraine headaches?

According to Brazilian scientists, a study conducted by researchers San Paolo, Brazil and reported in the August 24, 2004 issue of Neurology found that 3mg of melatonin administered thirty minutes before bed time reduced migraine frequency and intensity, and reduced the use of Triptans.1,2 Of the thirty-two patients who completed the study, twenty-five patients had at least a 50% reduction in headache frequency from baseline, eight patients had no headaches, and none of the patients had increased headaches after three months of therapy. Reduction in frequency was greater than 75% in seven patients, and 50% to 75% in ten of the patients.3

One theory for the effects of melatonin on migraine headache sufferers is that there is a correlation with an irregularity of the pineal gland, the producer of melatonin in the brain, which causes migraine sufferers to produce lower levels of melatonin than non-migraine sufferers.4 The administration of melatonin to these patients would help to correct the melatonin deficiency in these patients, thereby decreasing the incidence of migraine headaches.

There have been few side effects reported associated with the use of melatonin. Research testing the administration of melatonin found it safe in migraine sufferers.5 The few side effects that have been reported include headache, drowsiness, and upset stomach. Melatonin should not be taken by people with autoimmune disease, or by pregnant or nursing women, and should not be administered to children, as the effects of the medication are unknown in born and unborn children .6

While this information is encouraging for sufferers of migraine headaches, caution should be exercised before starting this, or any new medication regime, and your health care provider should be consulted before taking melatonin for the treatment of migraine headaches. Some things to consider include the fact that this study in Brazil was an “open label” study, which means that all the participants knew that they were taking melatonin.7 Open, or “non-blinded” studies run a greater risk of including inaccurate results due to placebo effect. Furthermore, the study of melatonin and migraine headaches is limited, and further study is warranted.

References
1. Peres, MFP, Zukerman, E, da Cunha Tanuri, F, Moreira F.R, and Cipolla-Neto, J. Melatonin, 3 mg, is effective for migraine prevention. Neurology. 2004;63:757
2. MedScape.com. Melatonin Decreases Migraine Frequency and Intensity. Available online: http://www.medscape.com/viewarticle/488935 (Downloaded: April 11, 2006).
3. Peres, MFP, Zukerman, E, da Cunha Tanuri, F, Moreira F.R, and Cipolla-Neto, J. Melatonin, 3 mg, is effective for migraine prevention. Neurology. 2004;63:757
4. Gagnier, JJ. The therapeutic potential of melatonin in migraines and other headache types. Altern Med Rev. 2001 Aug;6(4):383-9.
5. Gagnier, JJ. The therapeutic potential of melatonin in migraines and other headache types. Altern Med Rev. 2001 Aug;6(4):383-9.
6. AskYahoo.com. Is melatonin an effective sleeping aid? What are the side effects?” Available online: http://ask.yahoo.com/20001227.html. (Downloaded: April 11, 2006).
7. WebMD.com. Melatonin may help prevent migraines. Available online: http://www.webmd.com/content/article/94/102559.htm. (Downloaded: April 11, 2006).