Doing some research for a migraine patient recently, I came across a new article giving some credo to the use of IV magnesium for acute migraine pain. If you’ve ever had a migraine headache, you know how absolutely debilitating the pain and associated symptoms can be. The next time you’re triggered, it would be worth exploring the use of IV magnesium.
Here’s what the study found:
The paper I’m referring to was some preliminary work done by researchers in Korea, in the Korean Journal of Pain, July 2017.
Classic migraine headaches have proven to be somewhat difficult to treat in medicine – some patients respond well to NSAIDs with acetaminophen, others to triptans, and still others have no lessening of symptoms with either class of medication. Even if you get some relief, since NSAIDs have a short half-life, you’ll have to repeatedly take it to keep the pain at bay and side effects are common. In unresponsive cases, conventional docs will use strong analgesics with tramadol, barbituates, or even opioids like morphine. Caffeine is another common recommendation for migraine, and combinations of caffeine with analgesics (like codeine) help to shut down migraines in patients. Research has shown suboptimal magnesium levels in migraine patients, and for some, oral magnesium helps prevent migraines from occurring.
Some research has been done on IV caffeine for migraines, showing it to improve pain scores over a period of 3 hours from administration. In this study, IV caffeine was compared to IV magnesium during acute migraine episodes.
Study
The researchers used data from two different hospitals using two different IV formulas to reduce the severity of acute migraine pain: IV caffeine citrate vs. IV magnesium sulfate.
Data was collected from January – May 2016, on 70 patients with a mean age of 33.1 +/- 11.3 (64.3% female, 35.7% male). Their pain scores the hospital had to be severe or moderate in order to be included in the study.
Interventions
Patients received either of the following:
1. 60mg caffeine citrate intravenous infusion, within 10 minutes of presentation
2. 2g magnesium sulfate intravenous infusion, within 10 minutes of presentation
Both substances were diluted in 100ml of normal saline and given over a period of about 10 minutes. Patients were then asked to re-rate their pain at 1 and 2 hours after the IV.
Results
For the caffeine group: the median pain score (on the VAS pain score test) decreased significantly from 9.0 to 5.0 after one hour, and to 3.0 after two hours.
For the magnesium group: the median VAS pain score decreased significantly from 8.0 to 2.0 after one hour, and to 0.0 after two hours.
Researchers stated: “The VAS pain score decreased more in the Magnesium sulfate group compared to the Caffeine citrate group after one hour (P < 0.001) and two hours (P < 0.001).”
So what, you may ask?
Both IV caffeine and IV magnesium work for acute migraine, and IV magnesium works slightly better. IV magnesium is generally really well tolerated – there were no withdrawals due to side effects, and no significant adverse events were reported in either arm of the study.
I offer IV magnesium for acute migraines at Acubalance, and also I often take patients through food sensitivity testing and micronutrient deficiency tests in order to identify underlying causes of their migraines.
Call Acubalance to book in for IV magnesium as soon as you feel that migraine coming on, and book a free 15 minute phone consult with me if you’d like to discuss digging deeper into why you get migraines in the first place.
In health,
Kali MacIsaac HBSc, ND
Naturopathic Doctor