Supplementation with omega-3 polyunsaturated fatty acids in the management of recurrent migraines in adolescents.
OBJECTIVE
To examine whether dietary supplementation with fish oil rich in very long-chain n-3 polyunsaturated fatty acids might reduce frequency and severity of migraines in adolescents.


METHODS
Twenty-seven adolescents suffering from frequent migraines for at least 1 year (mean 4 +/- 1 years since migraine onset) participated in a randomized, double-blind, cross-over study consisting of 2 months of fish oil, 1-month washout period, and 2 months of placebo (olive oil). Participants self-assessed severity and duration of headache episodes (7-point faces and 10-point visual analog pain scales, 5-point frequency and severity rating scale) throughout the study. At the end of every 2-month treatment period, participants rated the effectiveness of treatment on a 7-point Likert scale (1,"not effective, not worthwhile"; 4,"moderately effective, moderately worthwhile"; 7, "totally effective, totally worthwhile"). A score of > or = 4 on the Likert scale was considered as improvement.


RESULTS
Twenty-three adolescents (16 girls, 7 boys, 18 Whites, 3 Hispanics, 1 African-American, 1 Cape Verdean, mean age 15 +/- 1 years) completed the study. Compared with frequency of headaches before the study (31 +/- 4 episodes/2 months), there was a significant (p <.0001) reduction in headache frequency during fish oil treatment (4 +/- 1 episodes/2 months) and during placebo (olive oil) treatment (4 +/- 1 episodes/2 months) but no significant (NS) difference between treatments. Likewise, self-assessment on a 7-point faces pain scale revealed a significant reduction in headache severity during fish oil treatment (2.9 +/- 0.5, p =.01) and during placebo (olive oil) treatment (3.5 +/- 0.4, <p =.03), compared with headache severity before study (5.0 +/- 0.3) and no significant difference between treatments. Patients' ratings of treatments revealed that 87% experienced reduction in headache frequency, 74% experienced reduction in headache duration, and 83% experienced reduction in headache severity during treatment with fish oil, compared with 78% who experienced reduction in headache frequency, 70% who experienced reduction in headache duration, and 65% who experienced reduction in headache severity during treatment with placebo (olive oil, NS). About 91% stated that they would recommend fish oil to friends or relatives with headaches vs. 91% who would recommend placebo (olive oil, NS).


CONCLUSIONS
Patients experienced a similar reduction in frequency, duration, and severity of headaches during treatment with fish oil and during treatment with olive oil. Although there was no significant difference between treatments, the marked improvement from baseline experienced by the patients suggests that the effect should not be dismissed as simply a placebo effect. In fact, results of this preliminary study suggest that both fish oil and olive oil may be beneficial in the treatment of recurrent migraines in adolescents. Further studies are warranted to compare each of these treatments with other interventions.
Harel
Zeev
Z
Divisions of Adolescent Medicine, Providence, Rhode Island 02903, USA. zharel@lifespam.org
Gascon
Generoso
G
Riggs
Suzanne
S
Vaz
Rosalind
R
Brown
William
W
Exil
Gerald
G
D000293:Adolescent; D000328:Adult; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002908:Chronic Disease; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000378:metabolism; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000378:metabolism / Q000517:prevention & control*; D000069463:Olive Oil; D010919:Placebos; D010938:Plant Oils / Q000008:administration & dosage; D012008:Recurrence; D012237:Rhode Island
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D000069463:Olive Oil; D010919:Placebos; D010938:Plant Oils