A 12-week randomized double-blind clinical trial of eicosapentaenoic acid intervention in episodic migraine
Wang H-F, Liu W-C, Zailani H, Yang C-C, Chen T-B, Chang C-M, Tsai I-J, Yang C-P, Su K-P (2024) Brain Behav Immun 118 459-467. doi: 10.1016/j.bbi.2024.03.019. Epub 2024 Mar 16.
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Abstract:
Omega-3 polyunsaturated fatty acids (PUFAs) may benefit migraine improvement, though prior studies are inconclusive.This study evaluated the effect of eicosapentaenoic acid (EPA) on episodic migraine (EM) prevention.
Seventy individuals with EM participated in a 12-week randomized, double-blind, placebo-controlled trial from March 2020 and May 2022. They were randomly assigned to either the EPA (N = 35, 2 g fish oil with 1.8 g of EPA as a stand-alone treatment daily), or the placebo group (N = 35, 2 g soybean oil daily).
Migraine frequency and headache severity were assessed using the monthly migraine days, visual analog scale (VAS), Migraine Disability Assessment (MIDAS), Hospital Anxiety and Depression Scale (HADS), Migraine-Specific Quality-of-Life Questionnaire (MSQ), and Pittsburgh Sleep Quality Index (PSQI) in comparison to baseline measurements.
The EPA group significantly outperformed the placebo in reducing monthly migraine days (-4.4 ± 5.1 days vs. - 0.6 ± 3.5 days, p = 0.001), days using acute headache medication (-1.3 ± 3.0 days vs. 0.1 ± 2.3 days, p = 0.035), improving scores for headache severity (ΔVAS score: -1.3 ± 2.4 vs. 0.0 ± 2.2, p = 0.030), disability (ΔMIDAS score: -13.1 ± 16.2 vs. 2.6 ± 20.2, p = 0.001), anxiety and depression (ΔHADS score: -3.9 ± 9.4 vs. 1.1 ± 9.1, p = 0.025), and quality of life (ΔMSQ score: -11.4 ± 19.0 vs. 3.1 ± 24.6, p = 0.007).
Notably, female particularly benefited from EPA, underscoring its potential in migraine management.
In conclusion, high-dose EPA has significantly reduced migraine frequency and severity, improved psychological symptoms and quality of life in EM patients, and shown no major adverse events, suggesting its potential as a prophylactic for EM.
FAB RESEARCH COMMENT:
In this new clinical trial, supplementation with high-EPA fish oils for 12 weeks showed significant benefits for patients with episodic migraine.For the corresponding news article, see:
Frequency and severity of migraines and associated disability were significantly reduced in those receiving the supplement vs placbo. Psychological distress (anxiety and depression symptoms) was also reduced, and overall quality of life improved.
Findings from previous clinical trials of 'omega-3 for migraine' have been regarded as 'inconclusive' - as most trials have been small, and with different formulations and dosages used. The current study - by leading experts in omega-3 and neuropsychiatry - used a dose of 2g/day of fish oils, providing 1.8g EPA daily.
Its findings are entirely consistent with those of two recent publications suggesting that omega-3 supplements may be a promising intervention for prevention and clinical management of migraine.
1) A review of evidence for the many different mechanisms by which omega-3 may help reduce migraines.
These include the ability of omega-3 EPA/DHA to reduce both inflammation and pain sensitivity (via many independent mechanisms), as well as their benefits for mitochondrial health and emotional regulation.
The authors also noted the established safety of these omega-3 in clinical trials across numerous different conditions.
2) A meta-analysis of clinical trials, showing high-dose omega-3 outperforms medications for migraine
High-dose omega-3 supplements were both more effective, and more acceptable to patients, than the best current pharmaceutical treatments for migraine, according to a network meta-analysis of 40 trials, involving over 6600 patients. See:Finally - rather than using supplements:
3) A dietary intervention to increase omega-3 EPA/DHA status has also been found effective in reducing migraines.
For details, see:
And for more information on omega-3 for the allevation of pain, see also the following lists of articles, which are regularly updated:
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