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.