Advances in Nutrition This study provides compelling evidence that high-dose prophylactic EPA/DHA supplements are effective.
Migraine is a common neurological disorder, with an estimated 9% to 18% of people worldwide suffering from it. In addition to the pain and discomfort associated with migraine, migraine is associated with reduced quality of life and increased risk of a variety of diseases and disorders, including depression, cardiovascular disease, and sleep disorders. Furthermore, migraine can lead to medication overuse and abuse in patients’ efforts to prevent and alleviate symptoms. Unfortunately, current pharmacotherapy and strategies have limited success in preventing and treating migraine.
Research suggests that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), two omega-3 fatty acids found in fish oils such as herring, mackerel, and salmon, may be promising treatments for preventing and treating migraines. But evidence from randomized controlled trials, the gold standard for clinical trials, is mixed. For example, researchers have yet to identify the most effective dose. Plus, the design of some studies means that a placebo effect cannot be ruled out.
In response, the authors of the study “Efficacy of High-Dose Anti-Inflammatory EPA/DHA for Migraine Prevention: A Network Meta-Analysis” conducted an analysis of 40 randomized controlled trials with a total of 6,616 participants to determine the effectiveness and safety of various combined doses of EPA and DHA in preventing and treating migraines. They then compared the results with FDA-approved or guideline-recommended drug treatments. The results of this analysis showed that: Advances in NutritionInternational Review Journal of the American Academy of Nutrition.
Rather than conducting a standard scientific evidence review, the authors chose a network meta-analysis, aiming to “improve the power of multiple comparisons of treatment effects and the possible superiority of individual pharmacological interventions at different doses, thereby providing important detailed evidence-based information that may guide future clinical practice.”
The results of this network meta-analysis provide “compelling evidence that high-dose prophylactic EPA/DHA supplements showed the highest efficacy and tolerability of all treatments studied and therefore can be considered a first-line treatment for migraine prevention.” The authors also found that EPA and DHA supplements showed similar levels of tolerability (i.e., the proportion of patients who dropped out of clinical trials for any reason) compared with other drug treatments or placebo. Finally, EPA and DHA supplements were associated with fewer adverse health events compared with placebo or other drug interventions.
According to the authors, “The most important finding of the current network meta-analysis is that EPA/DHA supplements are associated with superior preventive effects on migraine frequency and severity compared with other FDA-approved and guideline-recommended medications.”
The authors acknowledge that their analysis has certain limitations. In particular, due to the small number of randomized controlled trials investigating the effects of EPA and DHA supplements on migraine, “clinicians should not overinterpret the results of the current network meta-analysis and should apply them in a relatively conservative manner.” However, the results “provide a basis for designing future large randomized controlled trials to investigate the optimal dosage of EPA/DHA supplements in migraine patients.”
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