title: Nonmedication, alternative, and complementary treatments for migraine.
abstract: OBJECTIVE
  The efficacy of some nonpharmacologic therapies appears to approach that of most drugs used for the prevention of migraine and tension-type headaches. These therapies often carry a very low risk of serious side effects and frequently are much less expensive than pharmacologic therapies. Considering this combination of efficacy, minimal side effects, and cost savings, medications should generally not be prescribed alone but rather in combination with nonpharmacologic therapies.
  
  
  RESULTS
  In addition to the established nonpharmacologic therapies, such as biofeedback, relaxation training, butterbur, riboflavin, magnesium, and coenzyme Q10 (CoQ10) supplementation, recent data provide support for the use of aerobic exercise and acupuncture. Discovery of the high incidence of the C677T mutation of the methylenetetrahydrofolate reductase gene, MTHFR, and attendant elevation of homocysteine levels in patients with migraine with aura led to a trial of cyanocobalamin, folate, and pyridoxine in these patients. This trial showed that taking these three supplements resulted in a reduction of homocysteine levels and improvement of migraines.
  
  
  CONCLUSIONS
  Therapies proven (to various degrees) to be effective for migraine include aerobic exercise; biofeedback; other forms of relaxation training; cognitive therapies; acupuncture; and supplementation with magnesium, CoQ10, riboflavin, butterbur, feverfew, and cyanocobalamin with folate and pyridoxine.
authors.affiliation: New York Headache Center, New York, NY, USA. drmauskop@nyheadache.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Mauskop
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D000529:Complementary Therapies / Q000379:methods*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000150:complications / Q000628:therapy*; D008517:Phytotherapy / Q000379:methods