Migraine Prevention (adjuncts)

Adults with episodic migraine; coordinate with clinician.

neurology
headache
reduce attack frequency/days
improve quality of life

Core stack

Magnesium (citrate/glycinate)
B

Dose: 400–600 mg elemental/day

Divide BID with food

8–12 weeks before judging effect

Why: Recommended by headache societies; probable efficacy with good tolerability.

Riboflavin (Vitamin B2)
B

Dose: 400 mg/day

With food

12 weeks

Why: Mitochondrial support; reduced migraine days in several RCTs.

Coenzyme Q10
C

Dose: 100–300 mg/day

Split BID/TID with fat-containing meals

12 weeks

Why: Some trials suggest decreased frequency; overall evidence modest.

Not recommended

  • Butterbur (unpurified): Hepatotoxic PA compounds unless PA-free Rx-grade; many regions advise against.

Monitoring

  • Monthly migraine days
  • Acute med use