Parents frequently ask healthcare professionals to provide “natural” migraine care for their children, says Dr. Stewart Tepper at the Cleveland Clinic Foundation in Ohio.

Here’s what we know… and more.

Treating migraine

• Equivocal results in 1 randomized controlled study of magnesium
• Positive results from 1 uncontrolled study of magnesium

Preventing migraine

• Positive results in 1 uncontrolled study of coenzyme Q10
• Positive results in 1 uncontrolled study of Petasites (butterbur)

No studies of riboflavin or feverfew.

The bottom line?
Not much to recommend CAM here.

But what’s more interesting is Dr. Tepper’s clear categorization of studies as “controlled” and “uncontrolled.”

Let’s define terms.

In a “controlled trial” the first group of participants is treated with an experimental therapy. The results are compared to second group (the control) that receives no treatment.

Variations on this design include a “placebo-control” where the first group is compared to a non-active treatment, and an “active control” where the first group is compared to the best-known treatment.

Studies of migraine that are uncontrolled make it difficult (even impossible) for the researcher to say with confidence that the results seen occurred simply by chance, since there’s nothing to compare them to.

The US Food and Drug Administration requires pharmaceutical companies to conduct 2 controlled trials before a drug is eligible to be approved for use. I think it’s reasonable to expect at least 2 positive randomized controlled studies (or a positive systematic review of relevant research) before recommending any CAM treatment.

I’m not impressed by the argument that the big, bad pharmaceutical companies can afford to do these studies, and it’s too much to expect of CAM therapies.

To that I say balderdash. We’re talking about people’s health. Find a way to prove your claims before making them.

11/2/08 14:29 JR