Coenzyme Q10 Supplementation May Be Correlated With Resolution of New Daily Persistent Headache

New daily persistent headache is a chronic, treatment-resistant primary headache disorder with limited guidance on effective management. Despite its significant impact on headache-related quality of life, few studies have identified targeted therapies that contribute to symptom resolution. This study aims to describe the outcomes of pediatric patients diagnosed with new daily persistent headache and assess associations between specific interventions and headache resolution. A retrospective review was conducted using data from a patient registry at Children's National Hospital. Patients diagnosed with new daily persistent headache were included. Demographic characteristics, clinical features, prior treatments, and resolution rates were analyzed. Statistical comparisons were made between patients who experienced headache resolution and those with persistence of headache. A total of 182 pediatric patients were included (mean age: 15.5 years; 78% female). Headache resolution occurred in 47 patients (25.8%). For patients whose new daily persistent headache resolved, coenzyme Q10 (CoQ10) supplementation was the only treatment that reached statistical significance, being more frequently administered in the resolved group compared with the nonresolved group (17% vs 4%, <i>P</i> = .010). Additional treatments approaching statistical significance during resolution of new daily persistent headache included magnesium (<i>P</i> = .086), topiramate (<i>P</i> = .112), and onabotulinum toxin A injections (<i>P</i> = .179). Patients who engaged in regular exercise showed a trend toward higher resolution rates (<i>P</i> = .058). CoQ10 supplementation may play a role in new daily persistent headache resolution, with potential benefit from exercise, magnesium, topiramate, and onabotulinum toxin A injections approaching significance. Further prospective studies and randomized controlled trials are needed to establish causality and optimize treatment strategies for pediatric new daily persistent headache.