Background:Research has begun to uncover the likely role of melatonin in primary headache disorders such as migraine. The pineal gland produces the hormone melatonin and is largely influenced by environmental stimuli.Migraines often have environmental triggers with research starting to show lower levels of circulating melatonin found in migraineurs. Melatonin is an inexpensive, easily procured, and natural hormone with a minimal side effect profile compared to current pharmacologic migraine treatments. It is thought that migraine treatment with melatonin can decrease migraine occurrence, severity, and duration.
Methods: Exhaustive search of available medical literature was conducted on MEDLINE-PubMed, Clinical Key, CINAHL-EBSCO host using the keywords: melatonin and migraine. Inclusion criteria consisted of studies on the adult population, using immediate release melatonin, and on patients with classic migraines with and without aura. Quality assessment was conducted using GRADE.
Results: The search resulted in two studies. When comparing from baseline to month 3 of treatment with melatonin, a greater than 50% reduction in headache frequency was seen in 53% (32/60) of patients in one study and 78% (25/32) of patients in the other study.. Reduction of migraine frequency (in migraine days) was 2.7 and 4.6 fewer days per month, respectively. Reduction in migraine intensity (0-10 scale) was 3.5 and 3.8, respectively. Reduction in migraine duration per episode was 7.2 and 11 hours, respectively. All reductions were observed comparing baseline to month 3 of treatment with melatonin.
Conclusion: Prophylactic use of 3mg of melatonin daily for migraine prevention and symptom reduction was found to significantly reduce frequency, intensity, and duration of attacks when comparing patients baseline and after 3 months of treatment.
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