Evaluating Natural Compounds for Migraine Treatment: A Systematic Review

Abstract

Background: Migraine is one of the most common neurological disorders occurring globally and its treatment is currently based on synthetic drugs. Due to undesired effects associated with these agents, some of the patients might prefer natural compounds-based therapies that are cost-effective, efficacious, have more patient compliance and less adverse effects. Hence, this systematic review was conducted to evaluate the effects of natural compounds (single/combination) used for the prophylaxis or acute treatment of migraine. Method: Five electronic databases (PubMed, Scopus, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature (CINAHL) library and Web of Science) were searched from 1 March 2020–31 January 2024. We included studies that evaluated the effects of natural compounds on migraine through randomized clinical trials (RCTs) that reported the duration of migraine headache, severity and frequency of attacks as primary outcomes. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist was used to report the study while Cochrane Collaborations Risk of Bias (ROB) 2 tool was used to assess the ROB in included studies. The review protocol was registered on PROSPERO (CRD42023454998). Results: Twelve RCTs with 889 participants were included. Seven RCTs had low ROB and two RCTs had high ROB, while three RCTs expressed “some concerns”. It was observed that natural compounds including curcumin, topical basil, cinnamon, ginger, Vitamin D3 (Vit D3), zinc (Zn), magnesium (Mg) and cobalamin significantly reduced the severity of migraine headache. In addition, the duration of migraine attacks was significantly decreased by curcumin, cinnamon, ginger, Vit D3, Mg and cobalamin. Further, curcumin, topical basil, cinnamon, Vit D3, Zn, Mg and cobalamin exhibited significant beneficial effect on migraine frequency. In contrast, nanocurcumin and jodeungsan showed no significant results. Conclusion: The current findings suggest that natural compounds including cinnamon, Vit D3, Zn, Mg and cobalamin might mitigate migraine attacks and serve as interesting alternate therapies. Nonetheless, further large scale studies are highly desired.