Reduction in Migraine and Headache Frequency and Intensity with Combined Antioxidant Prophylaxis (N-acetylcysteine, Vitamin E and Vitamin C: NEC): A Randomized Sham-Controlled Pilot Study.
Pain Pract. 2020 Apr 19. Epub 2020 Apr 19. PMID: 32306462
Eric J Visser
OBJECTIVE: To investigate the preventive effects of a combined antioxidant drug known as NEC (N-acetylcysteine, Vitamin E and C) on migraine outcomes. Migraine is characterised by increased oxidative stress and neurogenic inflammation in the brain; therefore antioxidants may have a migraine preventive effect.
DESIGN: Randomized, double-blind, sham-controlled pilot study.
SETTING: Australian community.
SUBJECTS: Adults reporting 2-8 migraines per month for at least a year. Methods After a 1 month baseline period, 35 subjects completed 3 months treatment with NEC (n = 19) or sham (n = 16) capsules. The primary outcome was the difference in mean number of headaches per month between baseline and final month of the trial, for NEC and sham groups; secondary outcomes are listed below.
RESULTS: For NEC there was a significant decrease in mean number of headaches by 3.0 per month (p = .004) compared with 1.4 for sham (p = .073); there was no significant difference in these changes between the two groups (p = .052). Average monthly headache (p = .041) and migraine frequency (p = .018) were significantly less for NEC versus sham. In NEC subjects, there was a significant decrease in average monthly migraine days (-3.1), moderate/severe headache days (-3.2), migraine duration, headache pain scores and acute headache medication use.
CONCLUSIONS: This is the first RCT to find that combined antioxidant therapy with NEC reduces headaches and migraines in adult migraineurs. Given the limitations of this pilot study, an adequately powered RCT is planned to further investigate antioxidant prophylaxis in migraine.