Prophylactic Effectiveness of Coenzyme Q10 for Migraine in Adults: A Systematic Review and Meta-Analysis of Double-Blinded Randomized Clinical Trials

We aimed to evaluate the influence of coenzyme Q10 alone (CoQ10) or in association with other nutraceuticals (CoQ10+) on the frequency, severity, duration of migraine attacks, and quality of life. We conducted a meta-analysis and a network meta-analysis (NMA) according to PRISMA 2020. We searched PubMed, Web of Science, Google Scholar, and Europe PMC for eligible studies up to January 2024. We used R software for pooled outcomes. This meta-analysis was registered in PROSPERO (CRD42024499733). Five studies were included, with a total of 326 individuals with confirmed migraine. CoQ10/CoQ10+ was shown to be associated with significant improvement in migraine frequency per month, and migraine duration and severity. NMA indicated that CoQ10 combined with L-carnitine appeared to be more effective than CoQ10 on migraine frequency and severity (SMD= -0.99 [95% CI: -1,68 to -0,29]; SMD= -3.05 [95% CI: -4.05 to -2.04], respectively). CoQ10 associated with L-carnitine yielded the greatest significant decrease in migraine duration compared with placebo; NMA revealed no significant difference between CoQ10, CoQ10 with multivitamin, and CoQ10 with L-carnitine. Our findings suggest that for optimal effectiveness, the use of CoQ10/CoQ10+ should be prolonged for at least 3 months. Using CoQ10 had a significant effect on the improvement of the quality of life of patients with migraine. Our meta-analysis suggested a beneficial effect of CoQ10/CoQ10+ for reducing monthly migraine frequency, severity, and duration, notably when it was associated with L-carnitine. Additionally, CoQ10 significantly improved the quality of life.