Coenzyme Q10 Deficiency and Migraine Response to Supplementation
Abstract
COMMENT.Criteria for preventive treatment recommended as a benchmark by an expert panel are based on the headache frequency and degree of impairment.If headaches occur more than 2 days per month and result in severe impairment, or more than 3 days with some impairment, treatment should be offered.The authors stress, however, that in practice, the decision to treat is dependent on several factors.The study shows that migraine preventive therapy is underutilized.Whereas 39% of patients meet criteria for offering or considering preventive medication, only 12% of those responding to this survey currently receive it.Lack of proven efficacy reported by a panel of experts is one plausible reason for the under use of preventive medications in migraine.Of 12 agents reviewed by Committees of the Child Neurology Society and AAN, only one, the calcium channel blocker, flunarizine, which is unavailable in the US, has shown significant benefit in double-blind, placebocontrolled, crossover trial.Trials of antiepileptic medications, antidepressants, antihistamines, and antihypertensive agents have provided insufficient data, conflicting results, or have failed to demonstrate any effect (Lewis D et al.Neurology 2004;63:2215-2224).Perhaps the criteria employed by this panel of neurologists were too stringent.A more promising assessment of the effectiveness of propranolol, amitryptyline, and antiepileptic medications is provided by some reviewers (Modi S, Lowder DM.
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