Magnesium for migraine - Rationale for use and therapeutic potential

Magnesium deficiency can be assessed using serum ionised magnesium level, which appears to be a much more sensitive indicator of magnesium status than total serum or intracellular levels of this ion. In vitro and in vivo studies indicate that magnesium deficiency could play a contributing role in the pathogenesis of migraine in up to 50% of patients. In support of these findings, results from a single study indicate that intravenous infusion of magnesium sulfate can produce prompt and sustained relief of a migraine attack in half of patients. In this study, 85% of responders had low serum ionised magnesium levels, while 85% of non-responders had normal levels. Prophylactic oral magnesium supplementation has been shown to be effective in 2 double-blind trials. but ineffective in another. A possible reason for the lack. of response reported in the latter study could be poor absorption of magnesium from the preparation used. Chelated magnesium diglycinate appears to be one of the better absorbed preparations. Despite the absence of definitive large scale Studies, we recommend magnesium supplementation (chelated magnesium diglycinate 600 mg/day) in patients who experience migraine. This recommendation is based on the excellent safety profile and low cost of the supplementation, and the large amount of experimental and clinical data that support the use of this therapy.