Oral Riboflavin Versus Propranolol in the Prophylaxis of Migraine

Migraine is a chronic, often debilitating disease that affects 12% of the general population. The effective management of migraine involves the active treatment of acute episodes combined with non-pharmacological and pharmacological treatments for the prevention of migraine. The treatment of migraine with the reference prophylactic beta blocker propranolol (80-240mg/day) is limited by side effects and lack of tolerability. Riboflavin (vitamin B2) is the precursor of flavin mononucleotide and flavin adenine dinucleotide which are involved in mitochondrial transport chain. The use of riboflavin in migraine treatment is based on the hypothesis of a deficient mitochondrial energy reserve as a causal factor in migraine pathogenesis and on the findings of its safety and effectiveness at high doses (100-200mg/day) in the treatment of migraine like headaches in classic mitochondriopathies. Till date there have been four studies (two open trials and two randomized controlled) using high dose riboflavin (400mg/day) that suggest its safety and tolerability for preventing migraine in adults.Thus the present study though not statistically significant demonstrates that oral riboflavin 100mg/day